Withdrawal Form

Withdrawal form relating to the remote order made on / / 20


To be returned no later than fourteen (14) days after the date of delivery of the product(s) ordered. The period begins to run from the date of delivery of the product(s) ordered.

Return costs remain the responsibility of the consumer. Only the price of the product(s) purchased will be refunded. As indicated in our general conditions of sale.

The Customer must return the products within fourteen (14) days after using their right of withdrawal. The products must be returned in perfect condition, unused, complete in their original packaging, accompanied by a copy of the invoice and a copy of the withdrawal form.

This withdrawal is only valid if it is sent legibly and perfectly completed before the expiry of the deadlines called above to:

Pharmacie MAILLERET
PharmacieVosgienne.com
63 rue d'Epinal
88190 GOLBEY
FRANCE


The customer can choose another method of informing of his desire to withdraw, provided that this is unambiguous (by e-mail, by fax, by mail).

I, the undersigned, Name ......................................... ... First name .........................................
Address ................................................. .................................................. ....................
ZIP code ......................... .................................................. ........

Declares renouncing order no. ……………………….……. of ……………………… euro from / / 20


Date: / / 20
Name ............................................. Client signature .. .........................