Refund Eligibility Form

To apply for a refund, please complete and submit the form below.
Be sure to complete all fields to ensure your refund request can be processed in a timely manner.

By clicking SUBMIT, customers agree to the terms and conditions of the Refund Policy.

* Indicates required

Full name as it appears on the order *

Street address *

City *

Province/State *

Postal/Zip Code *

Country *

Purchase date

Order # or Transaction ID *

What is the batch number? (located on the underside of the jar)*

Is this your first order of Biolanyn?
YesNo

What is the full name of your skin condition? (Responses are confidential)*

To which part(s) of your body did you treat with the product?*

How many consecutive days did you apply the product? (The actual number of days you used the product).*

How many times per day did you apply the product?

Describe any improvements to the health and appearance of your skin

Telephone number (incl. area code)

Email address (required)

Biolanyn Skin Care is committed to protecting your privacy as a consumer. For this reason, we will never give any of your personal information out to anyone.

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