Customer Care Form

Please fill in all required fields so we can process your request appropriately and efficiently.

full Name *

company *

department / division *

site / unit *

Country of origin *

state / region ^{(if applicable)}

e-mail address *

phone number *

preferred language *

Manifestation Details

type of manifestation *

product *

Software Version * ^{(e.g., 1.15, 2.0, etc.)}

description of the manifestation *

Is this report related to an event that resulted in actual patient injury or death? *

YesNo

May we contact you for additional information? *

YesNo

Do you prefer to be contacted through a specific channel? If so, please specify below

By submitting this form, you declare that the information provided is accurate and agree to the processing of your data for service purposes, in accordance with IONIC Health’s Privacy Policy.

Automatic Submission

After completion, this form will be automatically sent to the official channel: customercare@ionic.health

Your form has been successfully submitted and sent automatically to our official channel.

We appreciate you taking the time to provide this information. Our team will carefully review your request and contact you as soon as possible.

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