URGENT Drug Recall Notice

URGENT Drug Recall Notice

To implement a return of a recalled product, please examine your stock immediately to determine if you have any product from the affected lot. If yes, immediately discontinue using the affected lot and quarantine the product. Complete this form as this will provide the documentation of your return for credit purposes. A member of the Amatheon team will follow up to finalize the details of sending your product for destruction.
Product Being Returned (if you have multiple products under recall notification, you must submit separate forms for each product)*
Quantity of the Product Being Returned (if you have multiple products under recall notification, you must submit separate forms for each product)*
Returning From Address: *

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Your Full Name*

First NameLast Name
Digital Signature*

Clear
Your Email*
example@example.com
ALL CREDITS WILL BE ISSUED UPON RECEIPT OF MERCHANDISE AND CREDITS ISSUED FROM THE MANUFACTURER.
Should be Empty:

ALL CREDITS WILL BE ISSUED UPON RECEIPT OF MERCHANDISE AND CREDITS ISSUED FROM THE MANUFACTURER.