Warranty Registration - ETHOS HEALTHCARE

Meter Registration Form

Select your product below and add the serial number found on the back of your meter.
Fields marked with (*) are mandatory as information will be required for proper e-warranty registration purposes.

Meter Type*

Meter Serial Number*

First Name*

Last Name*

Date of Birth*

Address

City

Postal Code

Email*

Contact Phone Number*

Where did you hear about our meter?*

How many times a week do you self monitor?

In what year were you diagnosed?

What type of diabetes do you have?

How do you control your diabetes?

What was your previous meter?

Meter Purchase Date

I understand and am aware that Ethos Healthcare SdnBhd (Ethos) maintains data base(s) where certain personal data about me under any program intiated by Ethos, any Agreement, or any purpose in which I transact with Ethos may be manually or electronically stored, processed and used

By executing this consent form, I hereby consent and authorize Ethos:
(i) to collect, store, process and use my personal data under the relevant Agreement or transaction into database(s) and for review or processing of the data or for being contacted by Ethos.

I understand that I may at any stage request for a copy of the information stored in Ethos database or for corrections to be made to such information. Further, I am aware that I may withdraw my constent for the collection or use or disclosure of my personal data by Ethos as long as I provide reasonable written notice of 30 days to Ethos.

I am happy to receive information from Ethos Healthcare Sdn Bhd by:
EmailPostPhoneSMSDo not wish to be contacted.
You can unsubscribe at any time by contacting us via the link “Contact Us” at the bottom

Meter Registration Form

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