Client Portal

Return Device Request

  1. Please complete all required information in the form below.
  2. After you click Submit, a confirmation page will appear.
    • Please save or print this information for your records.

"*" indicates required fields

This field is for validation purposes and should be left unchanged.

This request is not available for QC clients please contact the care centre for more information.

Province*
Please include any relevant information regarding the return of the head unit.