Returns / Exchange Authorization Form

Order / Invoice Number: Date Ordered: First name:* Last name:* Company (if applicable): Street address:* City:* State/Province:* Zip/Province code:* Country (if not USA): Email: Phone number:*

I would like to RETURN an item.
I would like to EXCHANGE an item.

How did you purchase directly from M.D.?*

MD by Phone MD Online Don't Remember

Items, quantity, and reason for return or exchange:*
Example: 353GC, hose, 1, exchange this for a different length hose.

Serial Number:
Enter serial numbers if you have them.

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* Your email address will not be stored in our system when using this submission form. The intended purpose of this form is to communicate with MD Central Vacuum, and your email address will only be used for that purpose.