MODEL CANCELLATION FORM
(Consumer Contracts (Information, Cancellation and Additional Charges)
Regulations 2013)

Complete and return this form only if you wish to withdraw from the contract.

To: Case Review UK
Email: enquiries@casereviewuk.co.uk
Correspondence address: 167-169 Great Portland Street, 5th Floor,
London W1W 5PF, United Kingdom

I/We hereby give notice that I/We cancel my/our contract for the supply of
the following service:

Service ordered: ....................................................

Order reference: ....................................................

Ordered on / received on: ...........................................

Name of consumer(s): ................................................

Address of consumer(s): .............................................

.....................................................................

Signature of consumer(s) (only if this form is notified on paper):

.....................................................................

Date: ...............................................................

Note: you have 14 days from placing your order to cancel without giving a
reason. If you asked us to begin work within that period, we may charge for
the work actually carried out up to the point you cancel, in proportion to
the full service. If the service is fully performed within the 14 days with
your express consent, the right to cancel is lost.