Claim Form - Vepalabs

Consumable Claim Form

Please complete this form as accuratly as you can, to claim replacement consumables for your clinic. Vepa has a very generous replacement policy but there are some reasonable requirements to meet. You must be running and maintaining your equipment properly, running any software updates and following correct QC procedures. If you have stock that you think might expire, you must let us know at least 28 days before expiry and we’ll replace it. We can’t accept claims for expired stock after that period. Most importantly, if you’re having difficulties running tests, call for help on 1300 837 252 to avoid downtime and wastage. Many thanks for your understanding.

Your name

Your clinic's name

Email address

Phone

Details of claim (the more information you provide, the faster we can process your claim. Include detail on what you're claiming and why, what happened etc..)

Please check all boxes. (or call us on 1300 837 252 if any don't apply. Only claims with all boxes checked can be processed)

We're not claiming multiple failed tests without calling tech support Our analyser has been maintained according to guidelines Our analyser is running the latest software version We have been following the correct QC procedure We're not claiming expired tests within 28 days of expiry

Serial number of any analyser involved (so we can check it's QC records)

Sales Order number - that the stock was ordered on (if multiple, seperate with a comma)

Upload any photos or documents to support your claim (optional)

Check this box to sign off on the above information being correct and complete.

If your claim is approved would you like a refund, or replacement stock?

Refund Replacement

We collect this information to process, respond to and othewise manage your claim for replacement consumables. Please do not share sensitive information on this form (such as credit card or account details). See our Privacy Policy for futher details on how we handle your personal information.