Refund / Exchange Request Form
The purpose of this page is to help expedite your refund or exchange request while providing customer feedback that allows us to do a better job. Please complete in full -- it only takes a few minutes -- and then hit "Send Message" at the bottom of the page. It is also helpful if you include a copy with your product return. Note: Receipt of this form is requisite to the processing of your request.
Those returning product should use the following address:
Customer Request : Refund Exchange
Title : Mr. Mrs. Miss Ms. Dr.
First Name :
Last Name :
Company :
Street :
City :
State/Province :
Zip Code :
Country :
Email Address :
Daytime Phone :
Extension :
Order No. :
Date of Order : ...
Please use the comment sections below to tell us:
(1) Which product(s)you ordered
(2) For what condition(s)
(3) Whether or not these condition(s) were diagnosed by a practitioner, what kind of practitioner (i.e. M.D., N.D., O.D., D.O., etc.), and if so, what that diagnosis was
(4) How you used the product (i.e. what dosage, method of application (is applicable), for how long, etc.), what happened along the way, and what was the final outcome - up to the time of your decision to return the product(s)
(5) Name other product(s), protocols, or modalities - if they exist - that have been helpful either as a treatment in your case, or as an adjunct
(6) Please indicate how you wish us to process your refund or exchange. If you want us to credit your credit card, provide card number and expiration date in the area below. If you want us to send you a check or money order, confirm the address (whether it is the one above or another address). If you want to exchange product(s), please indicate.
