Have you thought about how your going to execute this? Are you going to have to hand write on to the back every day/time you go calling to doors? Also some of the fields don't make sense....
They don't have an important order...so I would change this wording so that it is relevant to what you want from this flyer.
'Could not be delivered to you because'....'you were out' or 'Discounts available online'- that doesn't really make sense.
'Please see over leaf to see where you items have been delivered'- Wont make sense.
Also make it obvious from the back that your a designer for those oldies who just wont get it unless its spelled out.
I would work on the content here. If you want a clever design, it needs to look good but it also has to be smart and make sense. It has to fulfill a purpose that gets you more business. At the minute I think it will just confuse people and annoy them, designers and non designers.
To be honest I'm not sure this 'form' is going to benefit you or the client really. I'm not sure what it's purpose is?
Sorry again. :icon_hug: