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Customer Complaints Form

Section 1: Claimant:


(If the complaint involved more than one person please give us name and contact details)

(If the complaint involved more than one person please give us name and contact details)

Section 2: Faulty Product:


Section 4: Incident:


(e.g. fracture, laceration, bruising, etc)

(e.g. head, leg, finger, etc)

Section 5: Material Damage:


(e.g. furniture, carpet…)

(e.g. burned, melted….)

Section 6: Reporting (Major injuries, e.g. fractures, unconsciousness, dislocation; Hospitalised for more than 24 hours; over 3 days absence, including rest days, not including the day of the accident; Dangerous Occurrence, e.g. truck overturning):


Section 7:


(Please note than refund can occurred ONLY if product was bought on Ashleigh and Burwood web site. If not, please contact your supplier)

Section 8: Documents Attached (Please attach as many of the following documents as possible):