drclarkstore.eu

LOST/DAMAGED PACKAGE REQUEST FORM

Contact Information
First Name:
Last Name:
Street Address:
City, State/Providence:
Country:
Postal Code:
Day phone #:
Evening phone #:
Fax #:

Shipment Information
Date:
Shipment date:
Invoice Number:
Total Value (Including shipping):

Brief Description:

Loss
Damage
Shortage
Number of Packages:
Acknowledgment: I hereby declare that items were damaged/I did not receive the package. I also never received any notes from USPS in my mailbox regarding the package.

_______________________________
Signature

And Sign.

DO NOT E-MAIL this form.
Please Fax this form and a copy of your invoice to "+1-619-409-9501" or mail to the following address:
Self Health Resource Center
ATTN: Customer Service
RE: Lost Package
1055 Bay Boulevard, bldg. A
Chula Vista, CA 91911

OFFICIAL USE ONLY

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RECEIVED BY                                                                                                    DATE

DISCLAIMER NOTICE: These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure, or prevent any diseases. Although some of our customers may be interested in the research and statements of Dr. Hulda Clark, this company, its website and owner do not adopt any health or disease related claims based on her work or otherwise. Our products are not intended to diagnose, treat, cure or prevent any disease and we do not provide such information in any form. Although our products are in conformity with Dr. Hulda Clark's protocols, we are not owned nor operated by Dr. Hulda Clark. She does not sell any supplements on any websites, even if the websites appear to represent her. Please read full disclaimer here: http://drclarkstore.com/fudino.html.