Q3 2021 Promo Redemption Request

Canada Q1 2023 Promo Redemption Request

Request your free goods by using the form below. Must submit this form with invoice by 4/30/2023 to qualify. Offers valid only on purchases made between 1/1/2023 and 3/31/2023. If you have any difficulty with this form, please contact orders.usa@acteongroup.com.
Customer Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Customer/Office Email*
Office Name
Office Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Purchase or Upgrade Date*

MonthDayYear
Select the Promotion you are Redeeming for free goods/rebate.*
List the "other" promotion you are redeeming.

Select the two no charge Sopro Diagnostic cameras and docks (717, SoproLIFE or SoproCARE) that you are requesting. Must be of equal or lesser value. (Hold Ctrl or Command to select multiple products)
If you have selected the PSPIX $1000 rebate, please complete the information below for the person to whom the check should be made payable.
First Name   Last Name
Email
Street Address   Address Line 2   City   State   Zip
You bought 5 NEWTRON Tips, Select 1 tip that you are requesting.
You bought 10 NEWTRON Tips, Select the 3 tips that you are requesting. (Hold Ctrl or Command to select multiple products)
You bought 2 NEWTRON Tip Kits, Select 1 Newtron Tip Kit that you are requesting.
If you are requesting one of the Newtron rebates, please complete the information below for the person that the check should be made payable.
First Name   Last Name
Email
Street Address   Address Line 2   City   State   Zip
You bought 5 P2 tips, Select the no charge Piezotome II Tip that you are requesting.
You bought 10 P2 tips, Select the 3 no charge Piezotome II Tips that you are requesting. (Hold Ctrl or Command to select multiple products)
You bought 2 P2 tip Kits, Select the 1 no charge Piezotome II Tip Kit that you are requesting.
Select the Bliss Offer you are redeeming.

Bliss Buy 5, Get 1Bliss Buy 12, Get 3
Specify the no charge Bliss instrument you would like to receive. (Buy/Get promo only)
Specify the 2nd no charge Bliss instrument you would like to receive. (Buy/Get promo only)
Specify the 3rd no charge Bliss instrument you would like to receive. (Buy/Get promo only)
Select the promotional box of Riskontrol that you are requesting.

Please add any additional comments about your order here
Dealer Invoice Number*
Please upload a copy of your invoice*

Browse Files

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Terms and Conditions:
- One offer per invoice
- Prior sales outside promotion period are not eligible
- All requests are subject to validation by ACTEON North America and may be denied or disqualified at ACTEON North America's sole discretion
- Allow 4 - 6 weeks for delivery of free goods
- Free goods eligible on qualifying purchases made between 7/1/22 and 9/30/22 and are based upon product availability
- Invoice must be received by 10/31/22
- By requesting free goods or rebate, you consent to receive occasional product announcements and special offers via email from ACTEON North America
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Canada Q1 2023 Promo Redemption Request