Complaint form

Customer specifications
Name / Organization / Store
Caller ID
Phone and fax numbers*
E-mail
Address
Postal code
Product Specifications
Product description
Product Name
Date of production and expiration*
Serial number*
purchase date*
Description and type of complaint (problem that caused customer dissatisfaction)
- Product delivery (discrepancy in the number and time of sending and product information, etc.)
- Existence of quality and safety defects in the product
- Other
Complaint description*
Damage to the customer caused by non-compliance
Has the customer requested a troubleshooting solution?
- Yes
- No
Documents and products provided by the customer
Security code

Customer specifications