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Refund Request Form
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Name
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First Name
Last Name
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Email
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example@example.com
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Request Date
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Year
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4
Reason for Refund
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Language barrier
Course content was below expectation
Borken instructor relationship
I don't feel safe
I don't understand what do
I found a better course somewhere else
Technical difficulties
Personal or medical issues
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Course Name
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Please Select
PEBC Evaluating Exam Preparation
PEBC Qualifying MCQ Exam Preparation
Qualified Professional in Pharmacovigilance and Drug Safety (QPDS)
M0 Pharmacovigilance Introduction and Basics
M1 Drug Safety Regulation and Good Pharmacovigilance Practices
M2 Pharmacovigilance and Drug Safety Operations
M3 Safety Medical Writing, Quality and Compliance
Please Select
Please Select
PEBC Evaluating Exam Preparation
PEBC Qualifying MCQ Exam Preparation
Qualified Professional in Pharmacovigilance and Drug Safety (QPDS)
M0 Pharmacovigilance Introduction and Basics
M1 Drug Safety Regulation and Good Pharmacovigilance Practices
M2 Pharmacovigilance and Drug Safety Operations
M3 Safety Medical Writing, Quality and Compliance
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When did you enroll in this course?
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7
Please answer the followings
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Do you have the invoice?
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Row 0, Column 1
Have you read the refund policy?
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Row 1, Column 1
Based on the refund policy, are you eligible for a refund?
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Would you give us a chance to meet with you before issuing the refund?
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Row 3, Column 1
Do you have the invoice?
Have you read the refund policy?
Based on the refund policy, are you eligible for a refund?
Would you give us a chance to meet with you before issuing the refund?
Yes
Row 0, Column 0
No
Row 0, Column 1
Yes
Row 1, Column 0
No
Row 1, Column 1
Yes
Row 2, Column 0
No
Row 2, Column 1
Yes
Row 3, Column 0
No
Row 3, Column 1
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