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3003 SW 153RD Drive, Suite 209 | Beaverton, OR 97006 | 1.800.671.4525

Exchange / Return Form

Exchanges & returns are accepted within 30 days from the date you receive your order. You are responsible for shipping charges to return your merchandise; however, we do not charge restocking fees. Additionally, if you decide to place an exchange order you will not be charged for shipping. Product must be in new condition, unwashed with the tags still attached. Please allow up to two weeks for your return to be processed and your refund applied back to your account. If placing an exchange order, we will email you an order confirmation upon processing your request.

Reason Codes: Comments:

Did not Like Name:

Did not Fit

Defective

Wrong Item

Other

Order Date: Order #: Phone: Email: Color Size Description Dollar Value

Please Print Quantity

Address: Address: City, St Zip: Item #

Dollar Value Total:

$ Dollar Value

Exchange Customers: Fill in what you would like to order in exchange.

Quantity Item # Color Size Description

Dollar Value Total:

$

Mail To: NW Scrubs | 3003 SW 153rd Dr. Suite 209 | Beaverton, OR 97006

Office Use Only:

Date Received: # Items Rceived # Items Approved Completed By: Total Credit: Date Completed City, St Zip: Name on Card: Address:

Credit/Debit Card Information For Difference, If Any.

CC #: Expire: CCV# (SECURITY CODE ON BACK)

/

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Billing Information

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