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Adverse Event Form
If you have experienced an adverse effect from using one of our products, please fill out and submit this form. The FDA may reach out to you and/or your doctor to verify the accuracy of the submission as well as request more details.
• Person Affected
• Adverse Event
A life-threatening experience
A persistent or significant disability or incapacity
A congenital anomaly or birth defect
Other (not one of the above)
• Adverse Event Details
• Purchase Date
• Where Purchased
QOC Beauty Website
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