Lift Chair | Registration

Register Your Product

Product Information
Chair Collection*
Date Purchased*
Date Format: MM slash DD slash YYYY
Serial Number*
Product Model Number*
Dealer Information
Dealer Name*
If you purchased this product online, list the website
Dealer's Address
Street Address City State / Province / Region ZIP / Postal Code Country
Buyer Information
All information submitted will be kept strictly confidential. We will never share your information with anyone. This information will be used solely in the event that there is a product change about which we need to notify you as the owner of a product.
Full Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone
Optional Customer Information
Birthdate
Date Format: MM slash DD slash YYYY
Age
Weight
Height
Physical Limitations
Hobbies & Activities
Favorite UltraComfort Product Features
Agreement
I have read the owner's manual that accompanies this product and fully understand:
Check all that apply:*
- Product Warranty Information
- Safety
- Operation
- Care & Maintenance
- Adjustments for Operator Comfort
- Batteries & Battery Charging
- The function of Freewheel Levels
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