Product Complaint Form

Product Quality Complaint Form

For any complaints relating to the quality of our product, please complete this form.
Please note this does not include any unintended medical occurrence, for this please complete the ADR form.

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Complainant Information

Complainant Name

Contact Information

Response to Complaint Required:

Yes

Description

Detailed Description of Complaint

Must be between 10 and 250 words. Total word count: 0

Information On Product

Name of Product

Strength

Lot Number

Dosage Form

Expiry Date

Other Information

Complaint product sample available:

Yes

Forms

Product Quality Complaint Form

Complainant Information

Description

Information On Product

Verification