Reserve Your TENS Unit

First Name

Last Name

Phone *

Email *

Estimated Due Date *

When would you like your rental to begin? *

Choose your rental duration *

Shipping Information

City

State

Postal Code

Country

Special Delivery Notes *

I understand this is a rental service, and the TENS Unit must be returned in the prepaid return packaging provided.

I acknowledge that use of the TENS Unit is not a medical device prescription and should be discussed with my care provider.