Customer Complaint Form

At Injectech we are committed to the highest quality and service but we know that on occasion things don’t go quite right and when this happens, we are committed to finding a resolution as quickly as possible. Our Customer Complaints Form is here to explain how to get in touch and how we can help.

Simply fill out the form below and we will be in touch. Please give us 30 days (prior to samples being received) for full corrective/preventative action plan.

Customer Complaint Form

* Required fields are marked with an asterisk.

Please check the size of the value you provided for Name, the maximum size for this field is 4000 characters.

Name *

Please enter a valid Email Address

Please check the size of the value you provided for Email, the maximum size for this field is 4000 characters.

Email *

Please enter you company name

Please check the size of the value you provided for Company Name, the maximum size for this field is 4000 characters.

Company Name *

Please enter the part number

Please check the size of the value you provided for Part Number, the maximum size for this field is 4000 characters.

Part Number *

Please enter the batch number

Please check the size of the value you provided for Injectech Batch Number, the maximum size for this field is 4000 characters.

Injectech Batch Number *

Please enter your PO number below

Please check the size of the value you provided for Purchase order affected?, the maximum size for this field is 4000 characters.

Purchase order affected? *

How many recieved

Please check the size of the value you provided for Quantity received?, the maximum size for this field is 4000 characters.

Quantity received? *

How many affected

Please check the size of the value you provided for Quantity affected?, the maximum size for this field is 4000 characters.

Quantity affected? *

Tell us more about the issue

Please check the size of the value you provided for Description of issue, the maximum size for this field is 4000 characters.

Description of issue *

Tell us more about the issue

Please check the size of the value you provided for Impact of issue, the maximum size for this field is 4000 characters.

Impact of issue *

(initial inspection & AQL level, or in production)

Please check the size of the value you provided for When was the issue found?, the maximum size for this field is 4000 characters.

When was the issue found? *

(if yes, do you need a RMA)?

Please check the size of the value you provided for Are samples available to send back?, the maximum size for this field is 4000 characters.

Are samples available to send back? *

Please select yes/no

Please check the size of the value you provided for Do you have an internal SCAR form?, the maximum size for this field is 4000 characters.

Do you have an internal SCAR form? *

Let us know the action required

Please check the size of the value you provided for Select required action, the maximum size for this field is 4000 characters.

Select required action *

Please check the size of the value you provided for Do you have any images/documents?, the maximum size for this field is 4000 characters.

Do you have any images/documents? *

Please confirm you are not a robot.

We have been unable to verify your identity, please confirm you are not a robot.

Customer Complaint Form

Customer Complaint Form

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