To insure a prompt resolution for the items to be repaired please comply with the following instructions.

1. Include the fully completed Return Authorization form as well as any supporting documentation with the shipment to:
   
   Galvanic Applied Sciences Inc.
   7000 Fisher Road S.E.
   Calgary, AB Canada T2H OW3
   
   

2. All Returned shipments Must be shipped Prepaid. Galvanic will refuse any shipments sent back on a collect basis.

All Form Fields are Required

	Company Name:
	Name of primary contact for this RMA
	First Name:
	Last Name:
	Telephone:
	Email:
	Bill to:
	Address:
	City:
	Province/State:
	Area/Zip Code:
	Country:
	PO# and SO#:
	Reason for return: