In order to best organize and respond to client concerns, we have introduced this brand new product reporting form for any incident in which a product appears to be defective or a client appears to have been injured beyond the scope of expected adverse effects (redness, irritation or peeling).

Please submit this form and DO NOT email your sales rep directly.

PRODUCT INFORMATION: In this section we are requesting distinctive information about the product in question.

Occurrence Information : In this section please provide details regarding the individual affected.