Warranty Registration – Aus/Nzl Bodisure and selected Heartsure products.

First Name*

Surname*

Email Address*

Product Purchased*

—Please choose an option—BodiSure Cushion MassagerBodiSure Back MassagerHeart Sure Pulse OximeterHeart Sure BP100 Blood Pressure Monitor

Product Serial Number*

Purchase Date*

Place of purchase*

—Please choose an option—Australian PharmacyOnline within AustraliaAustralian Medical Wholesaler

Pharmacy/Retailer you purchased your product from?

If purchased Online name of Online Store:

Who influenced your decision to purchase*

DoctorPharmacistFriend or FamilyWebsiteAdvertisement Website/MagazineI received as a giftOther

Do you own other BodiSure Products*

BodiSure Cushion MassagerBodiSure Back MassagerI do not own any other BodiSure products

Please keep me up to date with BodiSure product information, updates and promotions*

YesNo