Register Aidex Warranty

Please fill in the form so we can verify your product

Full Name (as per Identification Card) *

Identification Card No *

Email *

Phone *

Please type in +country code e.g. +60

Transmitter Serial Number *

Date of Purchase (Aidex) *

Purchase device from? *

Pharmacy

Clinic

Other

Insulin Pump User (Aidex) *

Yes

No

Purchase device from? (please fill in if other)

Diabetes type (Aidex) *

Type 1

Type 2

Non-Diabetic

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