KELC | Product Incident Questionnaire

Product Incident Questionnaire
Kaplan Early Learning Company takes product safety concerns seriously and is committed to reviewing the matter promptly.

This questionnaire will help us gather the information needed to evaluate the incident and determine appropriate next steps. To support our review, please provide as much detail as possible, including photographs of the product, the incident location, and any product labels or manufacturer information when available.
Ticket Name
Please Provide Your Email Address
example@example.com
Do you know your business’s Customer Account Number used with Kaplan Early Learning Company?
Your Customer Number
Customer Details

Please include the information regarding who at your company may have ordered this product.
Billing Account Name
This is the name of the company used when purchasing the product and who Kaplan would have billed.
Purchaser's Name
The name of the individual who purchased this product.
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Purchaser's Phone #
Please enter a valid phone number.Format: (000) 000-0000.
Purchaser's Email Address
example@example.com

Customer & Order Details
Do you have an invoice number that contains the Order Details?
Do you have the Order Number or PO used for purchasing this item?
Kaplan Item Number (SKU)
Kaplan Order #
Invoice #
Customer's PO #
Many Customers have a PO# they use for documentation
Please describe the item purchased, include a hyperlink of the product from the Kaplan Website.
Order Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Item Received Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Vendor Item Details

Located on product, when avaialble
Vendor's Model #
On some products like toys, there will be the Vendor Model #
Lot #
On the product, there will be the Vendor PO # & the Lot #.

Additional Information
Please list names, emails, and phone numbers for any additional communication. (list as many as needed)
Please upload images and videos you have regarding this incident here.

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Any Additional Comments:
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Product Incident Questionnaire