Order form

Your Omeo Agent *

I have had a trial with my Agent *

Yes
No

Name *

First

Last

Phone *

Email *

Residential Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Intended use

Colour *

Control configuration *

Right Handed
Left Handed

Joystick configuration *

Right Handed
Left Handed

Omeo Accessories (please check the accessories you want to add to your order)

Off-Road Kit
Canvas Travel Cover
Off-Road Kit Carry Cases

Your Height *

Your Weight *

Measurement: Foot to under the knee *

Measurement: Inside knee to rear of seat* *

Comments

Promo Code (if applicable)

By placing this order I: *

have completed the Pre-Trial Assessment with my agent

By placing this order I: (copy) *

understand my Omeo will not be produced until I have had a trial and paid in full

By placing this order I: (copy) (copy) *

read, understood and agreed to the terms and conditions contained within the Purchase Agreement and Omeo Worldwide Warranty

By placing this order I: (copy) (copy) (copy) *

agree to Omeo Technology collecting my personal information in accordance to the terms outlined in the Privacy Policy

If you don’t receive a successful order recognition, please contact us directly at service@omeotechnology.com

Email

26344

Omeo Technology

We are a provider of innovative technology and cool design that continually push the boundaries and thinking behind movement and personal mobility.

We have a dedicated team providing ethical cutting-edge solutions to improve the lives of others.

Resources

FAQ
Omeo Technical Specifications
User Materials
Omeo Worldwide Warranty
Purchase Agreement
Privacy Policy
Patent Information

Contact Us

Hours
Monday-Friday: 9am-5pm (New Zealand)

Phone Number
+64 6 929 6548