Refund Request template

Everything a refund decision needs, collected in one pass: order number, purchase date, a categorized reason, photo evidence for damage claims, and the customer's choice between their original payment method and store credit with a 10% bonus. The credit option is a sample policy, not an automatic refund or a guaranteed way to retain revenue. Remove it if your business does not offer store credit.

Use this template Start free — no card

7 questions · Free plan: 500 responses/month · fully customizable

File upload question

Interactive — fill it in like a respondent would.Open full width

What’s inside

The questions this template ships with — rename, reorder, or delete any of them in the builder.

01Your contact detailsContact info

02Order numberShort text

03Date of purchaseDate

04Why are you requesting a refund?Multiple choice

05Photos of the item or packagingFile upload

06How would you like your refund?Multiple choice

07Anything else we should know?Long text

When to use this template

A Shopify or WooCommerce store routing refund requests through one structured intake instead of a shared inbox
A ceramics seller whose damage claims live or die on photos of the packaging — required here for damaged and wrong-item reasons
A small brand that wants to steer refunds toward store credit without making anyone ask for it
Event or ticket sellers handling refund windows where the purchase date determines eligibility

Tips to get more from it

The photo field's description says images are required for damaged and wrong-item claims — that expectation-setting saves an email round-trip per claim. The field accepts up to three images at 10 MB each.
The store-credit option carries its 10% bonus right in the option text. Adjust the percentage in the field editor to whatever your margins support; do not offer a bonus your team cannot honor.
The reason question allows Other. If Other answers pile up around one theme — say, sizing — add it as a real option so your CSV export stays analyzable.

Questions people ask

What information should a refund request form collect?

Order number, purchase date, a categorized reason, and evidence for damage claims — exactly the set this template ships with. With those four, most requests can be decided without any follow-up email.

Does this form process the refund payment?

No — it collects and structures the request. You issue the refund through your normal payment provider, and the form's responses give you everything needed to verify the order first.