Name and Surname(Required) Contact Number(Required)Alternative Contact Number(Required)Email Address(Required) Please select an option(Required)More InformationBook a Training SessionReport a Faulty ProductMessage(Required)Consent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors.HiddenBook a Training SessionSuburb(Required) Referring Doctor / Pharmacy Appointment Type(Required) Online In Person Additional RequestsConsent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors.Report a Faulty ProductAiDEX Sensor Replacement Review Please complete all information in as much detail as possible, to ensure a successful evaluation for sensor replacement.AiDEX 6 Digit Transmitter Serial Number: (eg. AH29SC)(Required) Sensor Insertion Date:(Required) Day Month Year Sensor Failure Date:(Required) Day Month Year Please Upload Screenshot of 24 Hour Sensor Graph: (example below)(Required)Max. file size: 512 MB.Sensor Insertion Site: (eg. Abdomen)(Required) Delivery Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If the sensor is eligible for replacement, do let us know about any additional notes or delivery instructions to the above address. (For example, choose option 2 when calling, avoid delivering on Fridays, etc.) Additional Information(Required)Consent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors. More Information Name and Surname(Required) Contact Number(Required)Alternative Contact Number(Required)Email Address(Required) Please select an option(Required)More InformationBook a Training SessionReport a Faulty ProductMessage(Required)Consent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors.HiddenBook a Training SessionSuburb(Required) Referring Doctor / Pharmacy Appointment Type(Required) Online In Person Additional RequestsConsent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors.Report a Faulty ProductAiDEX Sensor Replacement Review Please complete all information in as much detail as possible, to ensure a successful evaluation for sensor replacement.AiDEX 6 Digit Transmitter Serial Number: (eg. AH29SC)(Required) Sensor Insertion Date:(Required) Day Month Year Sensor Failure Date:(Required) Day Month Year Please Upload Screenshot of 24 Hour Sensor Graph: (example below)(Required)Max. file size: 512 MB.Sensor Insertion Site: (eg. Abdomen)(Required) Delivery Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country If the sensor is eligible for replacement, do let us know about any additional notes or delivery instructions to the above address. (For example, choose option 2 when calling, avoid delivering on Fridays, etc.) Additional Information(Required)Consent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors. Book a Training Session Name and Surname(Required) Contact Number(Required)Email Address(Required) Suburb(Required) Referring Doctor / Pharmacy(Required) Appointment Type(Required) Online In Person Report a Faulty Product AiDEX Sensor Replacement ReviewPlease complete all information in as much detail as possible, to ensure a successful evaluation for sensor replacement. Patient Name and Surname(Required) First Name Surname AiDEX 6 Digit Transmitter Serial Number: (eg. AH29SC)(Required) Sensor Insertion Date:(Required) Day Month Year Sensor Failure Date:(Required) Day Month Year Please Upload Screenshot of 24 Hour Sensor Graph: (example below)(Required)Max. file size: 512 MB.Sensor Insertion Site: (eg. Abdomen)(Required) Email Address(Required) Contact Number(Required)Delivery Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code If the sensor is eligible for replacement, do let us know about any additional notes or delivery instructions to the above address. (For example, choose option 2 when calling, avoid delivering on Fridays, etc.) Consent(Required) I hereby provide consent to Homemed (Pty) Ltd or any duly appointed representative, to use my personal information above with regards to, investigating AiDEX sensor issues and/or for the replacement of said sensors.