Employee Device Requests

Are you a VRI or Higi employee? You can get our devices at a 50% discount for yourself or a loved one.

How it works

See our devices below
Fill out the request form with your selection
We will reach out to you to finalize details and pricing. Pricing differs for each device. Employees are eligible for 50% off retail.

Name of Employee(Required)

Who is filling out this form?

Name of Device User(Required)

Who will be using the device?

Date of Birth of Device User(Required)

Phone Number of Device User(Required)

Country Phone Number

Email Address of Device User(Required)

Enter Email Confirm Email

Device Type(Required)

Address of Device User (no P.O. boxes)(Required)

You can use this address as the shipping address later on in the form, or, you can ship it to someone else.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Name of Device User's Emergency Contact(Required)

Emergency Contact’s Relationship to Device User(Required)

Phone Number of Emergency Contact(Required)

Country Phone Number

Who should receive the device shipment?(Required)

The device user (ships to address provided above)

Someone else (family member, caregiver, etc.)

Name of Shipping Recipient(Required)

Phone Number of Shipping Recipient(Required)

Country Phone Number

Address of Shipping Recipient (no P.O. boxes)(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is there anything else we should know?

Comments, questions, etc.