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Complaints
Complaints Form
Name
Date of Event
Email Address
Phone Number
Address
Are you the healthcare provider?
Select one...
Yes
No
Which healthcare facility did you receive/use our products?
Which product did you receive/use?
Select one...
SafeSplint
Bleed ID
Has the product already been disposed of?
Select one...
Yes
No
Product reference Number
Product Lot Number
Product Quantity
Event Details
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