Classify the request: A. Dispute Resolution – miscommunication between customer/dealer/DS rep (should be rare). B. Customer Service Remedy – where DS has failed to serve (DS specifically, not dealer or distributor): backorder, returns outside T&C's, or other exceptions. C. Other – where the issue is not addressed by the above classifications.
Information: Ensure all fields are complete. Incomplete submissions will delay review.
Summary: Provide a brief but complete narrative of the issue and its cause.
Documentation: Attach invoices and other supporting documentation.
Resolution Options: Provide more than one option for resolution to be considered.
Routing: Must originate with DS Sales Rep → RBM review/sign-off → AD review/sign-off. Unreasonable requests should be rejected and discussed.
Channel Sales: This form may be used for channel sales requests. Involve the channel sales team as appropriate.
Review Committee meets every 2 weeks, reviewing requests first-come-first-served. Committee decision is final.
Equipment and Technology — Dispute Resolution / CS Remedy Request
Dentsply Sirona · Connected Technology Solutions
Request Information
Customer Information
Internal Routing & Approvals
Note: Form must originate with DS Sales Rep, then RBM sign-off, then AD sign-off.
Reason for Request / Background / Summary
Recommended Resolution
Provide more than one option for resolutions to be considered.