Your name

Your email

Order Number

Reason for Return/Exchange
[radio* request-type use_label_element default:1 "Item Didn't Fit" "Received Wrong Item" "Didn't Like Product" "Item Damaged" "Received Order Late" "Other"]

Desired Resolution
[radio* resolution use_label_element default:1 "Full Refund, will ship product back" "Partial Refund, will keep product" "Exchange for Correct Item (size, design, etc)" "Other, will comment below"]

Additional Details/Comments