CUSTOMER COMPLAINT FORM — WORTHINGTON®

CUSTOMER COMPLAINT FORM

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Employee Taking Call (Only if Applicable)

Date / Time of call (Only if Applicable)

First Name

Last Name

Phone Number (Where you can be contacted)

Email Address

Please re-enter your Email

Mailing Address - Physical street address only. (P.O. Box not accepted)

Address Line 1

Address Line 2

City

State

Zip Code

Country

Please select the product you wish to report

Size of your product

What is the 12-digit UPC Code?

What is the lot number? (found on the side after the Best By Date)

Describe the problem: (Odor, color, taste, texture, allergic reaction, etc.)

Where was your product purchased? (Please name store or website)

When was this product purchased?

How was this product stored immediately before use? (Freezer, Refrigerator, Ice Chest, Cooler, etc.)

Is there something specific that you are asking Heritage Health Food / WORTHINGTON® to do or consider doing?

Thank you for your feedback!

Please know that we take all feedback seriously and we thank you for taking the time to reach out to us and let us know about your issue and we apologize for any inconvenience or disappointment you may have experienced.

Your issue will be investigated by the appropriate department in our company and if we have any other questions, a representative will reach out to you at the contact information you have provided.