Product Complaint

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Work address line 2* This field is required

Work address city* This field is required

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Patient's name (if applicable)

Please tick if this is a Nutricia Homeward patient.

Description of complaint (Please include a detailed description of the issue)* This field is required

Date issue occurred* Please enter a valid date

Name of product* This field is required

Batch number. This is required for a full investigation, if unknown, put unknown.* This field is required

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^{Nutricia Ireland Limited is a company registered in the Republic of Ireland with company number 106997. VAT Number IE4800652P}

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