Product Return Authority

Please use this form to register a claim for the DMK products you wish to return. Once this form is received and processed by DMK, an email will be issued advising your clinic of what we require next to proceed with the return. This email is sent within 7 days of receiving the return form.

Do not mail any products to DMK before we have emailed you to return the product/s, even if you have returned products before.

For returns that are due to a change of mind or mistakenly ordered, the cost of returning these items will be covered by your clinic. Products can be returned for these reasons up to 2 weeks after the products are received.

To assist in speeding up your return please add images of the faulty/damaged item.

Reactions should have their own returns form with only 1 reaction per form and images of the reaction attached. Please advise us if no images were taken.

Clinic Location*

AustraliaNew Zealand

Clinic Name*

Clinic Suburb*

Clinic E-mail*

Clinic Phone Number*

Area CodePhone Number

Please indicate the reason the product entered below is being returned. Please use seperate forms if you have products to be returned for different reasons.

Reason for Product Return....*

Please provide an explanation of why the item(s) are being returned*

Batch # of Products to be Returned

Use commas between multiple batch #s...

You have selected FAULTY OR DAMAGED PACKAGING.

This refers to a situation where you have received products and the container is damaged or malfunctioning allowing contents to leak.

Please indicate below whether you would like a replacement product or a credit to your account.

Upload photo 1 of the damaged products

Upload photo 2 of the damaged products

Upload photo 3 of the damaged products

If this return request is approved, please:*

Send replacement item(s)Provide a credit to my account without sending replacement items

You have selected INCORRECT ITEM INVOICED AND/OR SHIPPED.

This refers to a situation where DMK has either invoiced and supplied you with an item you did not order or, has invoiced you for a particular item but shipped a different item in its place.

As you have elected to return the incorrect item we will invoice and ship out the correct item as soon as possible. Once we receive the incorrect item back via the return process we will process a credit to your account.

You have selected PRODUCT RECALL.

This refers to a situation where DMK has identified and acknowledged a problem with a particular product and has issued a recall notice to all Clinics. In this situation please record the details of the items affected by the Recall Notice.

You will be advised in the Recall Notice whether you need to return the affected product or whether it should be destroyed.

Upload a photo of the Expiry Date and Batch Number

You have selected EXPIRED PRODUCT.

This refers to a situation where you have received a product of which at the time of receipt were not within their prescribed shelf-life as set out on the product. A return form must be submitted to DMK within 2 weeks of receiving the product.

We will invoice and ship you replacement stock if available. Once we receive the items with short-dated-expiry we will process a credit to your account for the value of the items originally shipped.

If this return request is approved, please:*

Send replacement item(s)Provide a credit to my account without sending replacement items

Upload photo 1 of the Expiry Date and Batch Number.

Upload photo 2 of the Expiry Date and Batch Number.

Upload photo 3 of the Expiry Date and Batch Number.

You have selected REACTION TO PRODUCT.

Please provide as much details as possible to ensure we can properly assess the return.

Images are mandatory - Please upload them in the field below, If you do not provide images of the reaction we may choose to decline a return. Exceptions to this requirement are internal reactions which can not be photographed.

Once your reaction return has been received we will also request the products back to finalise our assessment and a credit will be made to your account. No replacement products are sent out for reaction returns.

DETAILS OF ALLERGIC REACTION

If this return request is approved, please:*

Send replacement item(s)Provide a credit to my account without sending replacement items

CLIENT DETAILS

Client Name*

Date of Birth

Address

City/Suburb

State

Postcode

Phone

Mobile

Occupation

DETAILS OF ALLERGIC REACTION

Specify the details of the reaction*

Details of the reaction continued...

Food eaten that day

Immediate action taken to treat reaction*

Was a patch test taken?*

YesNo

Which part of the body was tested?*

TREATMENT INFORMATION

Last DMK Treatment*

Date

Of Last DMK Treatment

Last Non DMK Treatment

Date

Of Last Non DMK Treatment

PRODUCTS USED DURING TIME OF REACTION

DMK Product Used*

Batch Number

DMK Product Used

Batch Number

DMK Product Used

Batch Number

Non DMK Product Used

PRODUCTS USED TO CALM THE REACTION

DMK Product Used

DMK Product Used Continued...

Non DMK Product Used

Non DMK Product Used Continued...

REACTION OF SKIN

Colour*

Duration*

Sensation*

Instructions provided by DMK Skin Technician*

Instructions provided by DMK Skin Technician Continued...

Name of DMK Skin Technician*

MEDICAL INFORMATION

Medication taken during the reaction

Dosage

Doctor's Name

Add Image 1 of the Reaction

Add Image 2 of the Reaction

Add Image 3 of the Reaction

Add Image 4 of the Reaction

You have selected OTHER.

If the reason for your return is not one of the above please add your reason in the following box. Please note that a change of mind will not be accepted as a valid reason for a product return.

Reason.......

Please fill in the Item Name, Size, Quantity and Batch number of the product you wish to return in the designated fields, then click the "click to add this product" button (this will save the information you have entered and create a new field if you wish to add additional items).

Please note reactions should always be in a different returns form to faulty items.

An email will be sent to your clinic within 7 working days advising you of the next step in your return.

For returns that are due to a faulty/damaged/recalled/incorrectly supplied by DMK/Are not received within their prescribed shelf-life/Reaction item, a reply-paid address will be supplied.

For returns that are due to a change of mind or mistakenly ordered, a street address will be issued. The cost of returning these items will be covered by your clinic and the return will only be accepted if we have received notice of this mistake within 2 weeks of the products being received by your clinic.

Please ensure that products are packed safely with the address and authority number clearly marked.

Pick up Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Please indicate available pickup days and times.

Additional information

Return Authority Number

The number quoted above is your unique Product Return Authority (PRA) identifier. Please add this number to the package which is returned so we can match your PRA form with the products you return.

PRODUCT RETURN AUTHORITY FORM

REASON FOR PRODUCT RETURN

ITEMS FOR REPLACEMENT/ CREDIT APPROVAL

SHIPPING INFORMATION