Anestand Return Form

Company Name:(Required)

Customer ID:

Address:(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone Number:(Required)

Contact Name:(Required)

Contact Email:(Required)

Please state how product was used:(Required)

If used in medical setting please confirm product has been sterilized:(Required)

Yes

If sterilized please explain how/what was used:

Is the product broken or defective?(Required)

Yes

Sunset delivery or invoice number:(Required)

Please provide a brief description of what you like and dislike about Anestand:(Required)

Please do not discard tray.

Please allow 14 business day for credit/return processing.

A Sunset Return Request Number is required for all Returns.

Customer Service will provide Return Request number within 24-48 hours of receiving Return Form.

Return Anestand to the following address:

ATTN: Anestand Returns
YOUR RETURN REQUEST NUMBER
Sunset Healthcare Solutions
279 Madsen Dr
Ste 101
Bloomingdale, IL 60108

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