MANDATORY CUSTOMER RECORD FORM

Alltest Covid-19 AG Saliva Rapid Test (SELF-TESTING)
Customer Record

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Customer details are to be provided by the instruction of the Medical Devices Authority for recording purposes only. Any incomplete or false information can be fined by the Medical Devices Authority. All Personal Data Privacy Act policies will be in place to protect your personal data.


Please fill out this form completely and legibly..

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Customer Service
customerservice@globalscience.my

+603-7804 3822

Unit 816, Level 8, Block D, Kelana Square,
No.17, Jalan SS7/26, Kelana Jaya, 47301, Petaling Jaya, Selangor