Part Request Form - Ironman Fitness Gravity 4000 Owner's Manual

PARTS REQUEST FORM
Paradigm Health & Wellness, Inc.
EMAIL THIS FORM WITH YOUR RECEIPT OF PURCHASE TO
Service@paradigmhw.com
NAME:_____________________________________________________________ ________________________
ADDRESS:__________________________________________________________________________________
CITY:________________________ STATE:_____________ ZIP:_______________________________________
TELEPHONE: (Day)__________________________________________________________________________
(Night)________________________________________________________________________
SERIAL#:___________________________________________________________________________________
MODEL#:___________________________________________________________________________________
PURCHASE DATE:___________________________________________________________________________
PLACE OF PURCHASE:_______________________________________________________________________
PART # DESCRIPTION QTY
"YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS"
*This form can also be faxed to #: 626-810-2166
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