COVID Order Refund Request

Enter Your COVID Order Refund Request Below

Thank you for your refund request. We will cancel your appointment. The funds will return to your account in up to 2 weeks.

Enter Each Order Individually

COVID Order Refund Request

Nombre del responsable del pago(Obligatorio)
Appointment Date(Obligatorio)
Patient Name Patient Date of Birth Actions
   
Ningún paciente ha sido inscrito

Maximum number of patients reached.