ICU Medical, Inc. RGA Request
Red indicates a required field.

Step 1: Enter your PO or ICU Order Number, then press the Tab key to populate the information:
PO Number
ICU Order Number
Customer # and Lot Number
Step 2: Build a list of items you want to return by selecting the item number(s) and lot number(s) from the drop down box, then complete the rest of the requested information and click the Add button.  
You can submit everything you would like to return on one RGA request, whether you have multiple items from the same P.O. or items on multiple P.O.s.  
If you have items to return from multiple P.O.s, go back to Step #1 each time you finish adding items from the P.O. you are working on and enter the next P.O. number and press the tab key.  The items will be grouped by P.O. number.
Order Number
Item Number
Lot Number
PO #Item #Lot #QtyReason 

Step 3: Enter your contact information and click the Submit RGA Request button. The next screen confirms that your request has been received and is being reviewed for approval. You will not receive an RGA number at this time. Your RGA number and return instructions will be e-mailed to you upon approval of your request: :
Requested By
Distributor/Wholesaler Company Name
Contact Name
Contact Email
Contact Phone #
Freight Forwarder
Pro # / BOL PLEASE NOTE: If the product requested to be returned is not received within 90 days, the RGA will be closed.