28
PARTS REQUEST FORM
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
PART #
DESCRIPTION
QTY
Содержание EXERWORK 1000
Страница 5: ...3 LABEL PLACEMENT...
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Страница 11: ...9 HARDWARE TOOLS PACK...
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Страница 19: ...17 ASSEMBLY...