Customer Service Request Form

CUSTOMER SERVICE REQUEST FORM

_______________________ (Company) is committed to providing the best in Customer Service.? We do our best to resolve your request within 24 hours.? Please use this form for all customer service requests.

Date: _______________________________
Customer: ___________________________
Address: ____________________________
_____________________________________
Telephone: _______________________

Subject: _______________________
Type of Request: [Product Information/Order Status/Change Order/Cancel Order/Refund Order/Change Address/Other]
(Please select one)

Additional Notes: ___________________________________