• Adverse Reaction Reporting

    At Dermal Health Science, your safety and satisfaction are our top priorities. If you’ve experienced any adverse reactions while using our products, we want to hear from you. This form allows you to report any issues, so we can better understand and address your concerns. Your feedback helps us ensure the highest standards of quality and effectiveness in our skincare formulations. Please provide as much detail as possible, and our team will review your report promptly. We’re here to assist you in finding the best solution to your skincare needs.


     
  • Adverse Reaction Reporting

    At Dermal Health Science, your safety and satisfaction are our top priorities. If you’ve experienced any adverse reactions while using our products, we want to hear from you. This form allows you to report any issues, so we can better understand and address your concerns. Your feedback helps us ensure the highest standards of quality and effectiveness in our skincare formulations. Please provide as much detail as possible, and our team will review your report promptly. We’re here to assist you in finding the best solution to your skincare needs.


     
  • Order / Purchase Details


     
  • Order / Purchase Details


     
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  • Product Details


     
  • Product Details


     

  • Please describe in as much detail as possible

    product usage


     
  • Please describe in as much detail as possible

    product usage


     
  • Please describe in as much detail as possible

    reaction details


     
  • Please describe in as much detail as possible

    reaction details


     
  • Please describe in as much detail as possible

    actions taken


     
  • Please describe in as much detail as possible

    actions taken


     
  • Please describe in as much detail as possible

    your skincare regimen


     
  • Please describe in as much detail as possible

    your skincare regimen


     
  • Healthcare Professionals report


     
  • Healthcare Professionals report


     
  • Please include the Healthcare Professional report as well as photos of the reaction.

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  • Upload image/s
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  • Final decleration


     
  • Final decleration


     
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