NeuRx Recall Registration NeuRx Recall REF: 23-0021 (EPG), SN: 1900-2017 X/TwitterThis field is for validation purposes and should be left unchanged.Patient Name* First Last Email Address* Phone Number*Do you have access to backup ventilation?* Yes No Not Applicable Do you have a cardiac pacemaker?* Yes No Preferred Method Of Contact* Email Phone Address*NOTE: Please no P.O. boxes Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Serial Number of First Device*See example in photo belowSerial Number of Second Device*See example in photo below. (If not applicable, enter "n/a") By submitting this form, you give permission to Synapse Biomedical to contact you regarding this recall
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