Refund Request Form

Please answer the questions as accurately as possible. Once submitted, our team will review your request and contact you using the email address provided.

Your details

First name *

Last name *

Email address used at checkout *

Phone number

Order number *

Purchase date *

Health and background questions

How did you usually manage urine leaks before trying Efemia?

Other vaginal pessaries Tampons Disposable or washable pads

Do you have prolapse?

Have you ever given birth?

Your leak profile

Do you experience urine leaks?	Never	Rarely	Sometimes	Often
When you cough or sneeze
When you walk quickly, jog or exercise

Return instructions

After review and approval of your refund request, you will be required to send back your Efemia Starter Kit. Instructions and a return address will be provided.

Please note that costs associated with returning the product are not covered by Efemia Australia's Money Back Guarantee.