MediScan.nz Product Order Form

Product Order Form
- Full Name
  
  First NameLast Name
- E-mail
- Phone Number
  Format: (000) 000-0000.
- Postal Address
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip CodeCountry
- My Products
  prevnext( X )
  
  NFC Tag (without chain)$38.00 NZD
  NFC Tag with your information (supplied) embeddedColour as shown.Now pick your postage option
  
  Quantity
  Item subtotal:$0.00 NZD
  
  NFC Tag With Chain$45.00 NZD
  NFC Tag on chain (S/S) embedded with your info (supplied) Now pick your postage option
  
  Quantity
  Item subtotal:$0.00 NZD
  
  MediScan Medic Alert NFC Wristband $45.00 NZD
  MediScan Medic Alert NFC Wristband Silicone / Adjustable / Waterproof with your info (supplied) Now pick your postage option
  
  Quantity
  Item subtotal:$0.00 NZD
  
  MediScan Medic Alert NFC Wristband/2$45.00 NZD
  MediScan Medical Information Wristband / waterproof & comfortable /lite to wear. Comes with your info embedded. Now pick your postage option
  
  Quantity
  
  NZ POST - Within New Zealand$6.00 NZD
  Within New Zealand
  
  POST TO AUSTRALIA$20.00 NZD
  Post to anywhere in Australia
  
  Subtotal $0.00 NZDShipping $0.00 NZDTotal $0.00 NZD
- Additional Requests
- Please verify that you are human
- Payment Methods
  
  Choose from one of the PayPal options to make your payment.
- Should be Empty: