Your Details

First name

Last name

Company, Organization, Telemedicine Program

Please enter the best way to get a hold of you regarding this issue

Your email or phone number

How can we help?

How urgent is this issue?

Approximately when did this issue first occur?

Year

Month

Day

Time

HoursMinutes

Please describe the problem with as much detail as you can including any error messages that were displayed

Is this a one-time issue, or does it happen repeatedly?

Every time

Intermittently

Just once

If applicable, what is the device name and/or serial number

e.g., 19Labs-Test Device, 1234GHJ567GLE

Please upload up to 3 image or video files related to this issue