Return Authorization Form

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Return Authorization Form download

Instructions

  1. Complete the form below and submit it. It will be sent to support@mydxlife.com. If you are unable to complete this form, you can reach us by telephone at 800-814-4550 or 858-434-0705 from 7:00 a.m. to 5:00 p.m. Pacific time.
  2. A CDx Customer Service agent will contact you by email or telephone with the directions on to return your CDx product including a Return Authorization (RA) number for tracking.
  3. Ship the product back using the shipping label and box that came with the replacement.

NAME and ADDRESS:

First Name *:

Last Name *:

Address Line One *:

Address Line Two:

Address Line Three:

City *:

State *:

Zip/Postal Code *:

Country *:

Telephone #: *

Fax # *:

Email Address *:

MAILING ADDRESS (If Different Than Above):

First Name:

Last Name:

Address Line one:

Address Line Two:

Address Line Three:

City:

State:

Zip/Postal Code:

Country:

Telephone #:

Fax #:

Email Address:

Product Information

Product: *

Serial Number: *

Description Of Service Needed


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