Register BodiSure Warranty – New Zealand Only

First Name*

Surname*

Email Address*

Product Purchased*

—Please choose an option—BodiSure cushion massagerBodiSure back massagerHeart Sure Pulse Oximeter

Product Serial Number*

Purchase Date*

Place of purchase*

—Please choose an option—New Zealand PharmacyOnline within New ZealandNew Zealand 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