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First Name
Last Name
Street Address No PO Boxes
City
State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Zip / Postal Code
Phone Number Please format as XXX-XXX-XXXX
Email Address
What product did you purchase? (Select one). B10800 Prevantics Swab S40750 Prevantics Swabstick S41950 Prevantics Maxi Swabstick B19600 Prevantics Device Swab C71200 Prevantics Device Swab Large B123ST Prevantics Device Swab Strip X12048 Profend Nasal Decolonization Kit B60307 PDI Medium Alcohol Prep Pads C6990 PDI Large Alcohol Prep Pads B40600 PDI PVP Iodine Prep Pad - Medium S23125 PDI PVP Iodine Duo-Swab Prep & Scrub (1s) S41350 PDI PVP Iodine Prep Swabstick - 1s S41125 PDI PVP Iodine Prep Swabstick - 3s P13472 Sani-Hands Instant Hand Sanitizing Wipes (Medium Canister) P15984 Sani-Hands Instant Hand Sanitizing Wipes (Large Canister) D43600 Sani-Hands Instant Hand Sanitizing Wipes (Individuals) P71250 Sani-Hands Instant Hand Sanitizing Wipes (Bedside Pack) A2067542 Hygea Moist Toilet Tissue A500f48 Hygea Flushable Personal Cleansing Cloths J14143 Hygea Premium Multi-Purpose Washcloths J22750 Hygea Multi-Purpose Washcloths U12095 Hygea Multi-Purpose Washcloths (Individuals) D74800 Hygea Obstetrical Towelette Hygea Steril Saline Wipes M225XT Nice 'n Clean Baby Wipes - Scented (Softpack) M233XT Nice 'n Clean Baby Wipes - Unscented (Softpack) Q34540 Nice 'n Clean Baby Wipes - Scented Q70040 Nice 'n Clean Baby Wipes - Unscented D41900 PDI Castile Soap Towelette B16400 PDI Adhesive Tape Remover Pads B47000 PDI IO-Gone Iodine Remover Pads D25431 PDI See Clear Eye Glass Cleaning Wipes Q89072 Sani-Cloth Plus Wipes (Large Canister) Q85084 Sani-Cloth Plus Wipes (XL Canister) Q55172 Super Sani-Cloth Wipes (Large Canister) P86984 Super Sani-Cloth Wipes (XL Canister) H04082 Super Sani-Cloth Wipes (Large Individuals) U87295 Super Sani-Cloth Wipes (XL Individuals) A22480 Super Sani-Cloth Wipes (Softpack) P13872 Sani-Cloth AF3 Wipes (Large Canister) P72584 Sani-Cloth AF3 Wipes (XL Canister) M8063S80 Sani-Cloth AF3 Wipes (Softpack) H59200 Sani-Cloth AF3 Wipes (Large Individuals) U27500 Sani-Cloth AF3 Wipes (XL Individuals) P1450P Sani-Cloth AF3 Wipes (Pail) P2450P Sani-Cloth AF3 Wipes (Refill) P54072 Sani-Cloth Bleach Wipes (Large Canister) P25784 Sani-Cloth Bleach Wipes (XL Canister) P84172 Sani-Cloth Bleach Wipes (Clinical) H58195 Sani-Cloth Bleach Wipes (Large Individuals) U26595 Sani-Cloth Bleach Wipes (XL Individuals) P7007P Sani-Cloth Bleach Wipes (Pail) P700RF Sani-Cloth Bleach Wipes (Refill) P25372 Sani-Cloth Prime Wipes (Large Cnaister) P24284 Sani-Cloth Prime Wipes (XL Canister) H06182 Sani-Cloth Prime Wipes (Large Individuals) U13195 Sani-Cloth Prime Wipes (XL Individuals) P27372 Sani-HyPerCide Wipes (Large Canister) P26584 Sani-HyPerCide Wipes (XL Canister) P03672 Easy Screen Cleaning Wipes (Medium Canister) H01050 Easy Screen Wipes (Individuals)
Why are you unsatisfied with the product (e.g., damaged upon receipt, expired)? Please provide details.
Do you have a receipt or other proof of purchase? Yes No
Proof of Purchase I acknowledge that proof of purchase must be emailed to pdicustomercare@pdihc.com
Error Message: Proof of Purchase Required to Proceed. I acknowledge that I must provide proof of purchase to submit a Satisfaction Guarantee Claim
Where did you purchase the product Brick-and-Mortar Online (Amazon/Marketplace) Online (Retail Website)
Store Name
Store Address (inclusive of city, state and zip code)
Seller Name
How to Find Your Amazon Seller (No selection required.) From a Mobile Device/Amazon App: 1. Click on “Your Orders.” 2. Find and select the order containing the product. 3. Under the “Order info” section, click “View order details.” 4. Under the product name, look for “Sold by: [Seller Name]” to find the sellerFrom Amazon.com: 1. Click on “Returns & Orders.” 2. Find the order containing the product. 3. Under the Product Name, look for “Sold by: [Seller Name]” to find the seller.
Would you like a refund or a replacement product? Refund Replacement
Comments
Questions? Contact Us at pdicustomercare@pdihc.com