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Coupon Code or Distributor ID Number on Warranty Card
This is a 4 or 5 digit number at the top of your warranty card inside your insole package or stamped or written on marketing material.
*Name
Business Name
Phone Number
*Email
*Confirm Email
Shoe Size
Providing this information will help us provide you better customer service.
Street Address
Street Address 2
City
State or Province
Country
Zip Code or Country Code
Place of Purchase
Please tell us where you purchased Foot Relief Insoles. Name of Fair, Trade Show, Retail Location, or Website.
Purchase Price Including Tax
Question or Support Issue
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