Product Registration - Active Care Medical Cobalt Owner's Manual

Your ActiveCare product will provide you years of dependable service and mobility
ease. To validate your product's warranty, you must complete this form and return it to
ActiveCare Medical immediately.
Please print or type.
Your Name
Your Address
City
Phone Number
( )
Product Information
Model
Serial Number
Dealer Purchased From
Dealer Address
City
Phone Number
( )

Product Registration

E-mail Address
-
-
Thank you for purchasing an
ActiveCare power mobility product!
Date Purchased
Month
State Zip
/ /
Day Year
State Zip