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Submit a New Support Case

Please fill in the form to submit your support case.

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Dongle Number / Subscription ID

What would you like to report

Description

Date and time of the event

Vigilance Scanner Use

Vigilance User Description

Vigilance Intervention

Vigilance Health Status

Vigilance Other Equipment

First name

Last name

Phone number

Consent to not share personal data

Vigilance Creation Confirmation

Responsible Contact

Origin

Is Created On Weekend

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