Biotonix® order form - For more information (sizes, quantities) use the alternative order form or contact-us -

The unit price is Euros (includes shipping). The Biotonix® are delivered within 1 week in Europe, following reception of your order, . 

Select per Male or Female size ("US" as default format), the size of the Biotonix® insole pair :

Female :

   -

Male :

  

 

* For up-to-date correspondence to currencies use the Euro Converter.

Shipping address (fields marked with asterisk (*) indicate required information)

Full name*
Address line 1*
Address line 2
City*
Zip*

Country*
 

Your E-mail

(for order follow-up)

The information gathered in the questionnaire will only be used for the processing of your order and to satisfy legal requirements. If you wish, you can answer the following questions to help us to improve the service.

How did you hear from us ?
Which delivery timeframe would you expect for your order ?       

Payment : by credit card or by check.

a) by credit card, using the payment terminal at Credit Mutuel bank (Visa or MasterCard). Your credit card details are not known by the retailer, only by the bank secure server.

                     

(see order summary)   Home

b) by Fax +33 4 68 94 66 34. Please check the following information availability :  Name, Address, Size and type (Male/Female), Credit card references (Visa or MasterCard, Credit card number, Expiration date).

c) by bank check* to CSC, with a letter or print-out of the order form mailed to :  CSC, 7 Rue Frédéric Passy - BP 1302, 11493 Castelnaudary FRANCE. Please check the following information availability :  Name, Address, Size and type (Male/Female).

 

*  bank charges paid by the customer, if not French bank checks.

FDA-CDRH : Biotonix Device Establishment registration N° 9710314