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1.- IDENTIFICACIÓN DEL CONSUMIDOR RECLAMANTE

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Nombres*

Apellidos*

E-mail:*

Teléfono*

Tipo de DocumentoSeleccionarDNIC.E.

Número de Documento*

Menor de edad

Si es menor de edad, colocar el nombre de padre o madre

Departamento*

Provincia*

Distrito*

Dirección*

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2.- IDENTIFICACIÓN DEL BIEN CONTRATADO*

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Producto

Servicio

Canal de compra*SeleccionarVirtualTelefónicoPresencial

Fecha de incidente *

Monto reclamado*

Descripción

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3.- DETALLE DE LA RECLAMACIÓN Y PEDIDO DEL CONSUMIDOR *

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Reclamo: Disconformidad relacionada a los productos o servicios.

Queja: Disconformidad no relacionada a los productos o servicios o malestar o descontento respecto a la atención al público.

Detalle*

Pedido del Reclamante*

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4.- OBSERVACIONES Y ACCIONES ADOPTADAS POR EL PROVEEDOR

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Me encuentro conforme con los términos de mi reclamo o queja

La formulación del reclamo no impide acudir a otras vías de solución de controversias ni es requisito previo para interponer una denuncia ante el INDECOPI. El proveedor debe dar respuesta al reclamo o queja en un plazo no mayor a quince (15) días hábiles, el cuál es improrrogable.

*En caso no consigne como mínimo su nombre, DNI, domicilio o correo electrónico, reclamo, o queja y el detalle del mismo, de conformidad con el articulo 5 del Reglamento de Reclamaciones, su reclamo o queja se considera como no presentado.

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Enviar

[/fusion_text][fusion_text rule_style=»default» font_size=»20″ animation_direction=»left» animation_speed=»0.3″ hide_on_mobile=»small-visibility,medium-visibility,large-visibility» sticky_display=»normal,sticky» margin_top=»3%» margin_bottom=»10px»]

Agradecemos la información proporcionada, la cual será gestionada en estricta confidencialidad.

[/fusion_text][fusion_text rule_style=»default» font_size=»16″ animation_direction=»left» animation_speed=»0.3″ hide_on_mobile=»small-visibility,medium-visibility,large-visibility» sticky_display=»normal,sticky» margin_top=»0″]

farmacovigilancia@weppharma.com.pe | +51 965724022

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