Device Service Request Form - Digital Hand NW Skin Needling Device, Australian Clinics

Tester Request Form - Digital Hand NW Skin Needling Device

At KausmediTech, we understand that investing in a new device is a big decision, and purchasing without first hand experience can feel daunting. That’s why we offer you the opportunity to test our devices before committing to a purchase. This trial allows you to see, touch, and test the device in your own workspace, ensuring it meets your needs and expectations. Our goal is to help you make the right decision and feel confident and happy with your choice.
Cost Information

The trial cost reflects a commitment to an informed purchase, ensuring the opportunity is available to those genuinely interested in experiencing the device's value.

The cost to test a Digital Hand NW Skin Needling Device is $297 and covers necessary expenses outlined below:
- All related admin work
- Postage to send the device to you with extra cover for loss/damage during transit
- Use of tester for up to 1 week after receiving it
- 2 x needle cartridges to test the device with
- Return satchel for the tester to be returned to us after trial with extra cover for loss/damage during transit
- Quality check before and after the trial
- Maintenance of the tester
Payment can be submitted at the bottom of this form.

Should you choose to purchase the device within 1 week of your trial, we'll deduct the full trial cost from your purchase - making it even easier to move forward with confidence.
Do you wish to request a tester?*

Yes, I accept this cost and wish to proceed. - please fill out this form and provide the information we need to arrange your device to be assessed and repaired.No, I do not accept this cost and no longer wish to proceed. - sorry we are not able to assist further.

Clinic/ Salon Details - Required
Clinic name - Please include the branch location*
Clinic phone number*
Please enter a valid phone number.
Clinic address - If your clinic/salon is located in a large shopping mall, please include which level the clinic/salon is located and any other reference to prevent the parcel being delivered to another clinic in the centre.*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Primary Contact Details - Required
Name*

First NameLast Name
Role/position in the clinic*
Phone number*

Area CodePhone Number
Email*
example@example.com

Secondary Contact Details - Required (for us to contact if Primary Contact cannot be reached, must be different from Primary Contact Details)
Name*

First NameLast Name
Role/position in the clinic*
Phone number*

Area CodePhone Number
Email*
example@example.com

Treatment Training & Experience - Required
What previous trainings have you had in skin needling treatment?*
We will not be able to provide a tester if you have not had any previous training in skin needling.
How experienced are you in skin needling?*
Why do you wish to test a Digital Hand NW skin needling device?*

Tester Return Information - Required
To return the tester to us, please pack it in the prepaid Australia Post satchel sent with the tester and kindly lodge the parcel at the post office. A proof of lodgement must be obtained and emailed to service@kausmeditech.com.au. Do you agree?*

Yes.No, I do not agree and no longer wish to request a loan device.
If the parcel cannot be tracked at all for any reason and you have NOT provided the proof of lodgement, we will not be able to make any claims to Australia Post should the parcel go missing during transit. In this case, you will be held fully responsible for the loss of the loan device and charged the full cost of the device to the card provided for payment. Do you agree?*

Yes.No, I do not agree and I no longer wish to request a loan device.
The tester must be returned in the same condition in which it was received. If the device is damaged or any parts are missing on return, you will be responsible for the associated repair or replacement costs, which will be charged to the card provided for payment. Do you agree to this?*

Yes.No, I do not agree and no longer wish to request a loan device.

Payment - Required
You acknowledge and agree to us retaining your payment information to charge your payment card in the circumstances disclosed in this form.*

Yes.No, I do not agree and no longer wish to proceed.

Please choose the relevant fee/s and enter your card details for payment.*

Tester Trial Fee - Digital Hand NW_SN

$297.00AUD Quantity

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Should be Empty:

Tester Request Form - Digital Hand NW Skin Needling Device