Register Equipment for Warranty

Please complete this form when you set-up your purchased equipment. Warranty will start from date of sale or date of submission of this form.

Contact Details

Patient Name: *

Clinician Name: *

Address of fitting

The address of where the patient was fitted for the equipment.

Address line 1: *

Address line 2:

Town / City: *

Post code: *

Date of fitting: *

Device Details

Device type: *

Serial number: * Serial number can be found in the battery compartment.

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