BLOOD PRESSURE MONITORS
Thank you for purchasing a Microlife Blood Pressure Monitor. Please complete the information on this form and register electronically or you can dowload a form to print and send via mail or fax.

Microlife USA, Inc
1617 Gulf to Bay Boulevard
2nd Floor, Suite B
Clearwater, FL 33755

FAX: (727) 451-0492
  
DOWNLOAD FORM (pdf 14k)

* Warranty is only valid for home use. Warranty is invalid for professional use. Warranty is only valid for manufacturer’s defects.

NOTE: Warranties are only valid if this form has been completed and transmitted or mailed. Thank you.

ONLINE REGISTRATION - BLOOD PRESSURE MONITORS:  Items in red are required.

MODEL NO.
(on bottom of monitor or on plastic label of wrist units)
PURCHASE DATE  (mm/dd/yy)
FIRST NAME
LAST NAME
ADDRESS
CITY
STATE:   ZIP 
TELEPHONE   AGE 
EMAIL

Optional Questions:
1) Is this product for you or did you receive it as a gift?
2) Why did you buy this particular product? In other words, what attracted you to this particular product? (For example: Product features, Attractiveness of packaging, Price)
3) How did you learn about this product?
4) Is there anything we should change about the unit or the packaging of the unit? If yes, please describe.
5) Please check any of the following you are concerned about:
Allergies Blood Cell Count Cholesterol Salt
Arthritis Body Fat Hearing Stress
Asthma Calories Pulse Weight
Blood Sugars    
6) What is your annual household income?
Less than $40,000 $100,000 to $150,000
$40,000 to $75,000 $150,000 to $200,000
$75,000 to $100,000 Above $200,000
7) At what location did you buy this monitor?
Store
City
State
8) What was the price of the unit?
800-905-9499 Sales Inquiries | 800.568.4147 Technical Support
info@microlifeusa.com
© 2007 MicrolifeUSA
Privacy Policy