U Market Services

Cylinder Return Form

If you are returning a gas cylinder, please list the cylinder numbers in the "Reason for return" box.
Order Number the Item Was Originally On:
Enter Item Number and Quantity to be returned.
(Up to three items per order.):
Item Number (cx_ _ _ _ _) Quantity
Reason for the Return:
Pickup Address:
Room and Building*:
Street:
If we have Questions:
Contact*:
Email:
Phone*:
* Required fields