Warranty Registration Form

Thank you for choosing our Blood Glucose Monitoring System!

To register your meter, please complete this form within 30 days from the date of purchase.

Meter:

Date of purchase:

Meter Serial Number:

First name:

Last name:

Address:

Apt # / Unit (optional):

City:

State:

Zip:

E-mail:

Telephone:

Date of Birth (optional):

Which type of diabetes do you have?

Is this your first meter?

How often do you test your blood glucose level?