Candela Corporation | Resources | RGA Forms

RGA Forms

Billing Correction

Order Information You must submit either a valid order number OR a valid invoice number.

Order Number *

########
Invoice Number *

########

Customer Information

Customer Number

######
Company Name

Company Name

Contact Information

Name *

First

Last
Email Address

email@example.com
Phone

###

###

####

Ext
Fax

###

###

####

Pricing Discrepancy

Please describe the pricing discrepancy for this order below.