Please detach from the line (left) and type or print to fill out the form, and send to:
UK:
USA:
Serial#
Owner Name
Address
City
Additional Required Owner Information
Please indicate your understanding of your powered product by completing the following
information
.................. My dealer has instructed me on how to operate my powerchair.
I have read and fully understand:
.................. Owner's Handbook, especially the sections on operating insutrctions, safety
guidelines, maintenance and battery charging instructions.
................... Powerchair Warranty
Battery Instructions – only sealed lead acid or gel cell type batteries should be used.
Batteries must also be sealed, deep cycle and maintenance free or battery will hinder
vehicle performance and void the warranty.
Signature ........................................................ Dealer Name ..........................................................................
Telephone ...................................................... Dealer Phone .........................................................................
Email .........................................................................................................................................................................
Comments:
.......................................................................................................................................................................................
.......................................................................................................................................................................................
.......................................................................................................................................................................................
Drive Powerchair Range
WARRANTY REGISTRATION
Drive Medical Ltd, Ainleys Industrial Estate, Elland, UK HX5 9JP
Drive Medical, 99 Seaview Boulevard, Port Washington, NY 11050
.......................................................... Date Purchased ............. / ............. /.............
............................................................................................................................................
............................................................................................................................................
......................................................... Zip or Postcode ................................................
...................................................................................................................................................
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Z20945 (Rev C)