Product Recall Response Form
Recall handling that rebuilds trust: affected units, remedy choice, and safety check.
6 questions · 1 page · about 3 minutes to answer · fully editable after you start
Recalls are trust emergencies handled through forms. This response form does the job cleanly: affected product identified by batch or serial, purchase channel for the records, the remedy choice offered plainly, and the safety question – any incident before the recall reached them.
The incident capture matters beyond liability: customers reporting a near-miss and receiving human follow-up convert from plaintiffs to advocates surprisingly often.
Template preview
This is a picture of every question as a respondent would see it, so nothing on it can be clicked or typed into. Use this template to get your own editable copy.
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Page 1
Recall response
This form is for customers affected by a product recall. Tell us about the item you have and what you would like us to do, so we can put it right. It takes about 3 minutes.
Q1.Product name and batch/serial number (location described on the notice)*
Q2.Where was it purchased?
- Directly from us
- A retailer
- Online marketplace
- Received as a gift
Q3.Your preferred remedy*
- Replacement
- Full refund
- Repair where offered
Q4.Any incident or issue with the product before this notice?*
- None
- A minor issue
- An incident I should describe
Q5.What happened? (We will follow up personally.)
Asked only if the answer to Q4 is “A minor issue” or “An incident I should describe”.
Q6.Your contact details, so we can arrange the remedy*
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