Damage Form.

We’ll be very sad to hear of anything going wrong. But if anything does happen to arrive damaged please let us know by filing up the form within 12-24 hours of receipt so that we can register your claim. The name and photo associated with your Google account will be recorded when you upload files and submit this form.


Damage Form

"*" indicates required fields

Patient's Name*
Damage Condition*
Report within 12-24 hours of receipt?*
Drop files here or
Max. file size: 2 GB.