Customer Complaints– Codex Labs Corp

Name of Product as it appears on the box, bottle, or package*

Batch number (if applicable)

Expiry date (if applicable)

Date of purchase (DD / MMM / YYYY)

Type of supply

Retail

Online

Other

Name

Company

Address

Phone

Classification (if applicable)

Packaging defect (e.g. packaging broken or tampered)

Product defect (e.g. odour, physical properties such as viscosity, colour and deformation)

Undesirable Effect (e.g. allergy, irritation)

Other

Duration of use / application

Did you use any other cosmetic products (including make-up) on the day of occurence?

Yes

Do you use any anti-aging or acne products on a daily basis

Yes

Have you had a facial or other facial cosmetic treatment (e.g. masks, peels, dermabrasion) in the last ten days

Yes

Have you recently exfoliated your skin or used any topical products (i.e. creams, gels, serums, washes) containing Alpha Hydroxy Acids (AHAs) (e.g. glycolic, lactic acid), Beta Hydroxy Acids (BHAs) (e.g. salicylic acid) or products containing retinol or benzoyl peroxide in the last ten days

Yes

Do you use any products containing essential oils or fragrances on a daily basis?

Yes

Was a doctor, pharmacist, or other healthcare professional consulted?

Yes

If yes, please specify if symptoms were treated and how:

Any other information

Complaint Record Form