Fluent Forms Template Library

Refund Request Form Template

Refund Request Forms help you collect order details and refund reasons in one place for faster, more organized processing.

Refund Request Form

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Refund Request Form

Request Refund

YesNo
Do you have the invoice?
Have you read the refund policy
Based on the refund policy, are you eligible for a refund?
$

About this template...

A Refund Request Form helps businesses collect refund information in a clear, organized way. With Fluent Forms, you can create a streamlined refund process that captures customer details, order information, and the reason for the request without back-and-forth messaging. Customize the form to match your policies, add conditional fields for different refund types, and review all submissions from one clean dashboard.

Fluent Forms makes the process simple with its drag-and-drop builder, smart validation, and secure data handling. You can also connect payment gateways, email notifications, and storage integrations to automate the workflow. This helps support teams respond faster, reduce errors, and handle refund cases efficiently.

Refund Request Form

Features of this Template

  • Collects essential customer details such as name and email for quick verification
  • Numeric field for order number ensures accurate tracking and reduces processing errors
  • Text fields capture product or service details and specific refund-related information
  • Radio buttons let users select a clear refund reason or preferred resolution
  • Date field records the purchase date for easier validation
  • Textarea allows customers to provide additional context or explanations
  • File upload option makes it easy to submit proof of purchase or supporting documents
  • Required terms and conditions checkbox ensures users acknowledge your refund policy
  • Mobile-friendly layout simplifies refund submissions from any device
  • Ideal for eCommerce stores, digital product sellers, service providers, and subscription platforms
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