Follow the steps to successfully complete the Widex DFM39 form.

1. Click the ‘Get Form’ button to access the Widex DFM39 and open it for completion.
2. Begin filling out the account information section. Provide your account number, account name, shipping number, and current address, including city, state, and zip code. Additionally, enter the date and any relevant purchase order number, along with your clinician's phone number. Finally, include the name and email of your hearing care provider.
3. In the patient information section, enter the first and last name of the patient. Provide the serial numbers for the right and left hearing aids, as well as the model information for both hearing aids and any accessories returned.
4. Confirm the usage of the hearing aids in the appropriate section. Indicate whether the hearing aids were worn as part of a bona fide evaluation. If they were used, ensure that you do not select the bona fide evaluation box, and include the hearing care professional's signature and date if applicable.
5. Select the reason for the return from the provided list. This includes options like exchange, quality issue, financial decision, poor fit, and others. Choose the one that best fits your situation for an accurate return process.
6. Review the invoice date and return policy information. Ensure you adhere to the stipulated timeframes for returns to qualify for full credits.
7. Once all sections are completed, review your entries for accuracy. You can then save your changes, download the completed form, print it for your records, or share it as needed.

Complete your Widex DFM39 form online today to ensure a timely return process.