Complaint_DK - BVI Medical International

* Mandatory field

Company / Clinic / Hospital:
Customer Address: *
Customer Contact Name:
Customer Email: *
Customer Contact Number: *
Sales Representative Full Name: *
Sales Representative Email: *
Country of Occurrence: *
Reporter Data: *
Complaint Subject: *
Description: *
Part Number *:

Please only submit one part number per product complaint

Lot Batch/Serial Number: *
Customers Purchase Order Number:

Sample Available:

Available Quantity:
Date First Notified: *
Incident Date: *
Defect Type: *
Any Patient Impact As Result of Incident: *
Patient/User Impact Details: *

Filed with Authorities:

Add relevant attachment: (Max. 5 items)

Maximum upload file size: 25MB - File extension allowed: .pdf, .jpeg, .jpg, .png, .mp4

Ved at indsende denne formular forstår jeg, at mine indsamlede data vil blive brugt til at kontakte mig i forbindelse med denne anmodning.

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Cookie	Duration	Description
_ga	2 years	The _ga cookie, installed by Google Analytics, calculates visitor, session and campaign data and also keeps track of site usage for the site's analytics report. The cookie stores information anonymously and assigns a randomly generated number to recognize unique visitors.
_gat_UA-142478797-1	1 minute	A variation of the _gat cookie set by Google Analytics and Google Tag Manager to allow website owners to track visitor behaviour and measure site performance. The pattern element in the name contains the unique identity number of the account or website it relates to.
_gcl_au	3 months	Provided by Google Tag Manager to experiment advertisement efficiency of websites using their services.
_gid	1 day	Installed by Google Analytics, _gid cookie stores information on how visitors use a website, while also creating an analytics report of the website's performance. Some of the data that are collected include the number of visitors, their source, and the pages they visit anonymously.
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BrowserId	1 year	This cookie is used for registering a unique ID that identifies the type of browser. It helps in identifying the visitor device on their revisit.
CONSENT	2 years	YouTube sets this cookie via embedded youtube-videos and registers anonymous statistical data.
vuid	2 years	Vimeo installs this cookie to collect tracking information by setting a unique ID to embed videos to the website.

Cookie	Duration	Description
_fbp	3 months	This cookie is set by Facebook to display advertisements when either on Facebook or on a digital platform powered by Facebook advertising, after visiting the website.
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VISITOR_INFO1_LIVE	5 months 27 days	A cookie set by YouTube to measure bandwidth that determines whether the user gets the new or old player interface.
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