Please complete the necessary details below.

First Name *

Last Name *

Email *

Phone *

Model *e.g. "Vita X S12S", "S26 Verve", etc.

Serial Number (optional) e.g. ("S12XOAMX23...)

What is your enquiry about? *

Full description of required part/s *e.g. "2x batteries, 4x tyres with tubes"

Type of booking? *

Service - standard maintenance service

Standard Assessment - for diagnosing faults, quoting on broken parts etc/.

Battery Assessment - for assessment of battery health

Fitting / Programming / Other

Issues or concerns worth noting? (optional)

What is your address?

Address *

City *

State *

Postal code *

Requirements and prerequisites for lodging a claim:

The product must be registered for warranty.
A copy of the tax invoice must be supplied with this claim form.
Supporting photographs or documentation should be supplied with this form.
Out and About Healthcare is the exclusive repairer and warranter of its products and purchases.
Where charges apply, the customer will be notified before any charges are incurred.

Warranty process:

Please complete this claim form.
A technician may contact you to request additional information, or to request the the faulty part or product be returned for assessment.
Your product will be assessed and will be accepted or denied as a warranty claim.
You will be notified of the results of the assessment.

Purchase date *

Original invoice *

Details of claim *

Description of charging routine *How often the product is charged, used, and recharged

Please provide any photos that might help us with your enquiry (optional)

I.e. of a needed part, or for / fitment requests

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