By signing this card, you agree that The ROHO
Group may contact you in the future with
additional product or promotional support.
signature
3-Year Limited Warranty
Purchased From
Date Purchased
Is this your first ROHO cushion? Yes
No
Serial Number of cushion
(Printed on back of cushion along lip)
*Type of Product:
QUADTRO
®
SELECT
®
CONTOUR SELECT™
* The 3-year limited warranty is only offered on the above SELECT Cushioning Products.
1. How did you learn about
DRY FLOATATION
®
cushions?
therapist
friend
doctor
advertisement
dealer
3. How was your ROHO
®
cushion
paid for?
insurance
Medicare
self/family
Other_____________________
2. Why the ROHO system?
prescribed
suggested by a ROHO product user
unsatisfied with other brands
4. How many cushions do
you currently own?
1
3
more than 4
2
4
(Please specify)
REGISTRATION CARD
PLEASE COMPLETE, DETACH AND
MAIL FOR WARRANTY REGISTRATION
Name
Street No.
City, State
Zip & Country
Area Code & Telephone ( )
Email Address
User's Age?
18 and under
19-34
35-54
55-65
Over 65
PRODUCT INFORMATION