REPORT A PRODUCT ISSUE, DEFECT or ADVERSE REACTION All Quality Assurance forms are submitted with priority support. Product Name? Product Brand/ Trade names ====== Cosmetic Labs Private Label Product: OC Beauty: Staxs Mens: Botanica Essential Oils: IsoSan Medical: Other: Does The Product have An Expiration Date? Yes No I Do Not Know What is The DIN or NPN Number? Product Expiry (if on bottle) What Is The Lot # When Did You Purchase This Item? Where Did You Purchase The Item From? Upload The Receipt (If not purchased Directly From Cosmetic Labs Canada) If it is your Brand, What Is The Company Name? Your First Name Your Last Name Phone Number Email What is the issue with the product, How did you use it, What happened? Upload A picture Of The Product Relevant Problem/ Issue? Label Issue (Physical Issue, Colour, Adhesive) Adverse Reaction **Minor** Resolved Immediately with Discontinue Use Adverse Reaction **Minor** Resolved Immediately After Rinsing With Cold Water Adverse Reaction **Major** Unresolved, ongoing skin irritation 5 days Post usage. Area Affected **ONLY If Skin Reaction occurred** Face / Scalp/ Head Neck Chest/ Back/ Breast Pelvis/ Buttocks Penis, Scrotum or Perineum Vagina, Perineum Thighs/ Legs Ankles, Feet and or Toes Upload A Picture Of The Affected Area (If Caused Skin Irritation) Send
