Hire Request Form

Name *

First Name

Last Name

Phone *

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What product are you interested in hiring? *

Select as many options as you like.

Compression Boots

The VibroSound Pillow

Portable Ice Bath

Massage Gun

2-in-1 Shiatsu Foot and Leg Massager

Smart Knee Massager Infrared Heat Therapy

Neck & Shoulder Massager

Hand & Palm Massager with Heating

Smart Period Cramp Relief Heated Belt

Zero Gravity Shiatsu Massage Chair 3D Recliner

Dry Aqua Massage Bed

Infrared Wellness Cocoon

Preferred Hire Start Date

MM

DD

YYYY

Preferred Hire End Date

MM

DD

YYYY