Mask Satisfaction Guarantee

Please complete below form. * Required fields
If you are unable to complete this registration but meet the terms of this offer, please contact Philips Customer Care Team in Australia on 1800 830 517 and in New Zealand on +61 2 9151 0289.

Company name *

Claimant's name *

Contact number *

Australia New Zealand

+61

Contact email *

Listed below are the Eligible Products to be relaced due to patient dissatisfaction with how the mask fits.

Products description

Do not use this promotion for any quality concerns or damage related issues. Please contact Philips Customer Care Team in Australia on 1800 830 517 and in New Zealand on +61 2 9151 0289.

Fit Issues Reported (Please select all that apply) *

Patient preferred a differed nose fit

Patient preferred a differed fit around the mouth

Patient preferred smaller size fit

Patient preferred larger size fit

Patient mouth breathing

Patient reported feeling of claustrophobia

What mask did you provide as replacement? *

Manufacturer

Mask name

Please attach proof of this transaction here. * (File limit exceeded. Total attachment files cannot exceed 10MB)

Click here to upload the documents

By checking the box below, you acknowledge you have read the consent and agree to proceed *

^† Terms and Conditions apply, please click here for more details.

Philips Sleep and Respiratory Care

30-Day Mask Satisfaction Guarantee Request Form
Australia and New Zealand ^†

Registration Confirmed

An email confirmation will be sent to your nominated email address

Philips Sleep and Respiratory Care

30-Day Mask Satisfaction Guarantee Request Form Australia and New Zealand †

Registration Confirmed

An email confirmation will be sent to your nominated email address

30-Day Mask Satisfaction Guarantee Request Form
Australia and New Zealand ^†