Exchange & Return Authorization

This is a Return Authorization Request. Your return is not guaranteed until you have received the final return authorization form via email.

When returning a product, please note the following:

All returns are subject to approval.
Products must be returned unused, in their original packaging, and in sale-able condition.
Place product in a shipping box to prevent damage during transport.
Any returns after 30 days from invoice date are subject to a 20% restocking fee.
Sterile products cannot be returned.
Special order items and/or items that are noted "non-returnable" may not be returned.
All refunds are subject to a 5% processing fee, except in cases of defective items or fulfillment issues.

All questions with a red asterisk * must be completed before submitting the form.

Invoice Number*

Date of Purchase

Doctor's Name*

First NameLast Name

Practice Name*

Name of Person Completing the return*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Email*

example@example.com

Choose type of transaction*

Return for creditReturn for exchange

Item to be Returned*

Reason for Return*

Return for Exchange, please include the item you would like to exchange with the returned item. IF YOU SELECTED RETURN FOR CREDIT, please type NA in this field.

Return shipping fees are the customer's responsibility and are nonrefundable. A return shipping label can be provided for you out of convenience (except for international returns); however, it will be charged to your account.*

Include return shipping labelDO NOT include return shipping label

International Returns: Return shipping for international orders must be arranged and paid for by the customer. Outbound shipping charges are non-refundable. Any duties, taxes, brokerage, or customs fees paid on the original shipment are also non-refundable. Returns must include tracking; we are not responsible for items lost in transit. Any duties, taxes, brokerage, or customs fees incurred on the return are the customer’s responsibility. Refunds are issued after the return is received and approved.

Returns that are accepted outside the 30 day return window may be subject to a 20% restocking fee.*

I understand and agree

Return & Exchange Authorization