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Return Authorisation and Pickup Form

RadSafe is committed to our customers and ensuring all products procured are satisfactory. If in any event, where you believe the item received is faulty or is not to the ordered specification, please complete and submit the following Return Authorisation and Pick up Form and a member of the RadSafe team will contact you to arrange a pickup.


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  1. Contact Details

  2. Full Name(*)
    Please let us know your name.
  3. Email(*)
    Please let us know your email address.
  4. Phone(*)
    Please let us know your email address.
  5. Company or Organisation Name(*)
    Invalid Input
  6. Department(*)
    Invalid Input
  1. Return Details

  2. Reason for the Returnig(*)
    Invalid Input
  3. A 20% restocking fee applies for change in an event you have changed your mind on the purchase as well as the additional freight charges
  4. Is it a Radsafe Apron?
    Invalid Input
  5. Enter the RadID
    Invalid Input
  6. Invoice or Delivery note
    Invalid Input
  7. Photo of Issue or damage
    Invalid Input
  1. Pick Details

  2. Pick-up Address
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  3. Number of items or boxes to be picked up(*)
    Invalid Input
  4. Item or box size L x W x D (mm)
    Invalid Input
  5. Whats is the Approx weight (kg)?
    Invalid Input
  6. Specific Pick-up instructions (Gate/ floor)?
    Invalid Input
  7. Item to be sent back to Imaging Solutions?(*)
    Invalid Input
  8. Specific Delivery Instructions
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  9. Is there a Secondary contact to coordinate pickup?(*)
    Invalid Input
  10. Secondary Contact
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  11. 2nd Contact Email
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  12. 2nd Contact Phone
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  13. Whats a suitable Date and time for pickup(*)

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