Name:_________________________________________
Address:_______________________________________
Phone:______________________Postcode:___________
Email address:___________________________________
State the item(s) you wish to return:
1_________________________________ Date of Purchase:_____________
2_________________________________ Date of Purchase:_____________
3_________________________________ Date of Purchase:_____________
4_________________________________ Date of Purchase:_____________
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(please tick) Yes, all the receipts for all the items above are included.
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State the reason why you wish to return the above items:
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
Scan/email or Mail this Form To:
www.thehealthplace.com.au
720 North Road,
Ormond, Victoria, 3196,
AUSTRALIA
After reviewing this request for a refund, we will either:
-
Agree that you receive a refund - Your money for the above goods will be
refunded to you by the same method that you paid for these items, eg.
If you paid by credit card, we will add credit to your credit card for the amount
to be refunded.
-
Disagree that you receive a refund - If your request does not meet our
terms and conditions, no refund will be granted.
We will inform you if your request has been granted by email or phone.
Your Signature:___________________________
Your Name:______________________________
Date:_______________ (Date must be within 30 days of the "Date of Purchase" above)
