Customer Complaint Form

Complaint details
Date complaint received*

YearMonthDay
Complaint Description*

0/4000
Internal notes/additional comments/info from Sales what has been communicated to customer

0/2000
Photos of the issue

Cancelof
Photos of the packaging and case labels

Cancelof
Follow up actions needed? (i.e. if customer request to send them an investigative report)*

YesNo
Product details
Product Category*
Sample available?*

YesNo
Product Category
Stock Code(s)
Purchase channel*

Direct from DaiyaDistributor (specify)
Purchase channel details
Purchase Order number*
Quantity affected*
Pack size
Best Before/Expiry Date*

YearMonthDay
Lot number (with timestamp)*
Incident Location details
Business name*
Street address 1*
Street address 2
City*
Country*
State
Province
Postal / Zip Code*
Customer Contact details
Full Name*
Email*
Phone*
Daiya Sales Account Manager
Name*
Email*
Please verify that you are human*
CountryText
StateProvinceText
ProdCategoryText
Should be Empty: