Report Shipping Discrepancy

Shipping Discrepancy Request Form

This form is for documenting overage, shortage, or damaged shipping discrepancies. Provide your company information and the required information in the noted fields.

  • All claims must be reported within 72 hours of receipt of product
    OS&D Policy
  • Issuance of this form does not guarantee acceptance or promise of credit.

For future claims, access to Halyard’s Internet Customer Portal will provide automatic population for many fields. Click here to register.

  • MM slash DD slash YYYY
  • Details of Shipping Discrepancy

    Enter the HYH Catalog Number, quantity ordered and received. Then, click on the drop down box and indicate the type of discrepancy and requested action to be taken.
  • Your 8-digit Halyard customer account number. This can be found on the invoice under the heading cust/loc.
  • This is the 8 digit number that is found on the bill of lading, usually beginning with a 2 or a 4.
  • Accepted file types: jpg, gif, png, pdf, xls, dox, Max. file size: 5 MB.
    File attach (Upload size limit=5MB. jpg, gif, png, pdf, xls and doc files)
  • * Please complete the Shipping Discrepency details (at least 1 item)

  • Please enter a number from 0 to 5000000.
  • Please enter a number from 0 to 5000000.
  • Please note that upon successful transmission of your Shipping Discrepancy request, you will receive an automatic confirmation. If you do not receive a confirmation, please contact the Concerns Team at OSDConcerns@hyh.com.
  • This field is for validation purposes and should be left unchanged.