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Refund Processed
Refund Processed
Customer Name
*
Enter Customer Billing Name
Refund Type
*
Full Refund
Partial Refund
Refunded Amount
*
Reason for Refund
*
Cancellation of Document Replacement
No Therapist Available
Duplicate Order
Removed Item from Order
Evaluation Rejection
Order Never Arrived
Package Lost
Missing Items
Disgruntled Customer
Other
Which Items Refunded from order?
Document Replacement
Shipping Method
Therapist Letter
Housing Form
DOT Form
Certificate/ID
Vest
Leash
Collar
Other
What State Do they Live in?
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
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New Hampshire
New Jersey
New Mexico
New York
North Carolina
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Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
Additional Notes
If other, disgruntled customer, etc please explain.
Refund Approved by
*
Addie
Erika
Alex
Andrew
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