Follow the steps to fill out the Complaint Form - Dentsply.

1. Press the ‘Get Form’ button to obtain the form and display it in the online editor.
2. Begin with the section labeled 'Selling Location/DI Division.' Enter the name of the selling location and the complaint reference number provided by that location.
3. In the 'Customer/User' section, input your Customer ID or practice stamp, along with your name, street address, and contact phone number.
4. Next, specify the failed product by selecting the appropriate category such as 'Implant,' 'Component,' or 'Tool.' Fill in the product's name, catalog number, and lot number, if available. If the product is unknown, ensure to select that option.
5. In the 'Event' section, provide the date of the event and indicate the issue experienced, such as 'No Primary Stability' or 'Implant Loss.' Answer subsequent questions as to whether it was possible to complete surgery with another implant or tool.
6. Enter additional information to describe the problem in detail, using the open text field provided.
7. Continue through the form by providing relevant medical history, implant placement dates, and other applicable information requested in the subsequent sections.
8. Once all relevant fields are completed, review your information for accuracy. You can then save changes, download or print the form, or proceed to share it as needed.

Complete your complaint process online by filling out the Complaint Form - Dentsply today.