NASK N95 Fit Test Form

NASK N95 Mask Fitting Booking Form

11 Lorong 3 Toa Payoh,#01-13, Jackson Square Block B, Singapore 319579 Phone : (65) 6336 0806
Name*

PrefixFirst NameLast Name
Phone Number*

Phone Number
E-mail*
Please pick 2 preferred date and time in the appointment calendar below:
Preferred appointment slot 1*
Preferred appointment slot 2*
Number of people who wants to be mask fitted*
Please read before submitting:
1. Please give us 1 working day to process your fit test form and send you a confirmation email on the confirmed appointment slot.
2. The location will be at our office: 11 Lorong 3 Toa Payoh, #01-13, Jackson Square Block B, Singapore 319579.
3. The mask fitting session will be around 30minutes.
4. Each time slot is in 1 hour interval.
5. The mask fitting session have a cost fee of $25/pax before GST. This includes 2 sizes of NASK N95 mask.
*If you have any questions, please give us a call 6336 0806 directed to Wendy or email to mktg.sg@easmed.com.

Thank you!
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NASK N95 Mask Fitting Booking Form