Product Registration Form - TiLite TRA AERO T Owner's Manual

Name:
Address:
City:
Zip/Postal Code:
Email:
Model:
Purchased From:
1. Method of purchase: (check all that apply)
Medicare
2. This product was purchased for use by: (check one)
Self
3. Reasons for purchasing a TiLite:
Reputation
Advertisement: (Please Specify)
4. Were your expectations met in the following areas? If not, please specify.
Quality of Service:
Timeliness of Delivery:
Quality of Product:
5. What additional features, if any, would you like to see on this or future TiLite products?
OM_Aero T_TRA_0414RevB

PRODUCT REGISTRATION FORM

Register online at tilite.com or
complete and mail this form.
Insurance Medicaid
Parent Spouse
Dealer Relative
Yes No
Yes No
Yes No
State/Province:
Country:
Phone:
Serial #:
Date of Purchase:
Other
Other
Friend Therapist/Doctor
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Aero T/TRA Owner's Manual