34
PARTS REQUEST FORM
PART #
DESCRIPTION
QTY
Paradigm Health & Wellness, Inc.
EMAIL THIS FORM WITH YOUR RECEIPT OF PURCHASE TO
NAME:
______________________________________________________________________
ADDRESS:
___________________________________________________________________
CITY:
________________________
STATE:
_____________
ZIP:
________________________
TELEPHONE:
(Day)
________________________________________________________
(Night)
_______________________________________________________
SERIAL#:
____________________________________________________________________
MODEL#:
____________________________________________________________________
PURCHASE DATE:
____________________________________________________________
PLACE OF PURCHASE:
________________________________________________________
“YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS”
* This form can also be faxed to #: 626-810-2166
Summary of Contents for AIR ELLIPTICAL
Page 5: ...3 LABEL PLACEMENTS ...
Page 8: ...6 OVERVIEW DRAWING ...
Page 11: ...9 HARDWARE TOOLS PACK ...