RETURN/EXCHANGE FORM 1. Sign and fill out this form completely. Incomplete/incorrect information will delay your return/exchange. 2. Mail all packages to: MIS Implants Canada Inc 700 Bord du Lac, Suite: 100 Dorval, Qc, Canada 3. Include this form along with your return/exchange items. RETURNS OR EXCHANGES Customer Name_________________________________________________________________ Address________________________________________________________________________ Telephone #_______________________________ Invoice #_____________________________ Invoice # of original order being exchanged or returned Reason for exchange RRTURNED PRODUCT CODE
DESCRIPTION
Return (R) / Exchange (EX)
QTY
TOTAL
EXCHANGEDD PRODUCT CODE
TERMS AND CONDITIONS FOR RETURNS 1. 2. 3. 4. 5. 6. 7. 8.
Shipping Charges are non-refundable unless return is due to company error. All returns must be received within 30 days of the date you receive the package. No refunds on opened or damaged products. We are not responsible for lost or stolen returns/exchanges. Customer is responsible for return/exchange shipping charges. All refunds will be applied to customer account as a credit. Biomaterials must have an existing shelf life of 6 months before expiration Returns & Exchanges are only accepted for items purchased within 6 months of the invoice date
CUSTOMER SIGNATURE:_______________________________________________________