Refund request form
A refund request is the first step, not the last—it gets information to you, but issuing the money is still something a person does. This form keeps refund reasons as a select field rather than free text, so damaged, wrong item, and changed mind are trackable categories instead of a sentence for every request. A photo of the problem is optional, not required, so a customer can file while they think of it without hunting for a device to photograph the issue.
The form beside this text is live. Fill it in and submit it — it validates exactly as it would for a real respondent, and saves nothing.
Reason is a fixed select, not free text
A select field with four reasons—damaged, wrong item, changed mind, other—turns "I don't want it anymore" and "it came broken" into trackable categories. Free text produces a mix of spelling, tone and length that reads as unique stories rather than patterns in refund causes.
Photo upload is optional, not required
An optional file field for damage photos does not block a customer who is filing fast—they can upload a picture later or reference it in an email. Making file upload required locks out anyone without a camera on hand, which is why this field lets them skip it.
This one uses file uploads, which is a paid feature — you can build and edit it on the free plan, but saving it needs an upgrade.
No card required.
Refund Request Form
Live previewHow to build this form
5 steps in the editor.
- Add text and email fields for the customer's name and contact details.
- Add a text field for the order number and a date field for the purchase date so you can look up the original order.
- Add a select field for the reason: damaged, wrong item, changed mind, or other. These fixed options let refund requests be sorted by category rather than read individually.
- Add an optional file upload field for a photo showing the problem, and an optional number field for the refund amount if it is a partial refund.
- Add a dropdown for preferred refund method—original payment method, store credit, or other. A customer states their preference but you still confirm and process it outside the form.
Fields in this form
8 fields, using 6 of the 19 field types available.
| Question | Field type | Required |
|---|---|---|
| Full name | Short text | Yes |
| Yes | ||
| Order number | Short text | Yes |
| Purchase date | Date | Yes |
| Item purchased | Short text | Yes |
| Reason for refund | Select | Yes |
| Photo of issue | File upload | Optional |
| Refund amount (partial or full) | Number | Optional |
What goes wrong with this form
Specific to a refund request form, not general advice about forms.
Reason as free text, not a select field
Free text produces "it's broken", "broken :(" and "BROKEN"—three entries that all mean the same thing but sort separately. A select field with four reasons—damaged, wrong item, changed mind, other—groups real patterns instead of reading unique sentences.
Required file upload for damage photos
Making photo upload required blocks a customer who is filing immediately, before they photograph the damage or find a device to capture it. Leave it optional so they can file fast and send photos later or by email if needed.
Missing purchase date, so you have to ask
Without a date field, you cannot find the original order without a phone call to the customer. A date field is what makes the request self-contained—you can look up the purchase in your system from what they type.
Questions about this form
How do I create a refund request form?
Add order number and purchase date fields so you can look up the transaction. Add a select for the reason—damaged, wrong item, changed mind—so refund requests sort by category. An optional file field for damage photos and an optional amount field for partial refunds round it out. A person still approves and processes the refund in your payment system.
Does this form process refunds automatically?
No—it collects the request, reason, and contact details. A person reviews each one and issues the refund through your own payment processor or banking system. The form is the intake, not the payment.
Can a customer upload a photo of the damage?
Yes, the file upload field is optional—they can attach an image if they have one, but the form does not require it. A written description of the problem is enough to file the request.
This one uses file uploads, which is a paid feature — you can build and edit it on the free plan, but saving it needs an upgrade.