Home Career Email Live Chat
 

» Urology
» Gastroenterology
» Radiology
» Women's Health
» Nephrology
» Oncology
» Surgery
 
 
 
 
Product Complaints
 
If you have experienced any problems or complaints with any Surgimedik product, please take a moment to complete the following complaint form. The information you provide will allow Surgimedik to fully evaluate the problem & take measures to prevent a reoccurrence. Please provide as much detail regarding the incident as possible.
 
Initiated By :
Name *:
Address *:
City*:
Country*:
Zip/Postal Code:
Telephone*:
Email*:
Lot No.:
Nature Of Complaint:

Date Of Occurrence: Type of Procedure :
Technique: Approach :
No. of reuses: Method of Sterilization :
Patient Involved: Quantity Involved :
If Yes, ( Required by FDA)
Patient Name:
Age of Patient:
Weight: Sex:
Diagnosis:
Past Medical History:
Sign me up for SURGIMEDIK®'s newsletter
Enter Below text here* :
 
(* Feilds are mandatory)
 
 
 


 
About Us | Products | OEM | Contract Manufacturing | Complaints | Distribution Form | News | Events | Careers | Contact Us
Terms of Business | Warranty | Sitemap
 
Copyright © 2012 SURGIMEDIK . All Rights reserved. Designed by DreamSoft IT Solutions Pvt. Ltd.