Massaging Insoles Return Merchandise Authorization (RMA)


Original Date of Purchase: date of purchase is required.
Size of Insole:
Sold by/ Preferred
Customer Coupon Code:
First: First Name required.
Last: Last Name is required.
Address: Address is required.
City: City is required.
State/Province: Please select an State.
If no State or Province select None!
Zip/Postcode: Zip Code is required.
Phone: Phone is required.
Email: An Email address is required.
Reason for Return: