Mr Ms.
Name__________________________________________________________________________________
Address________________________________________________________________________________
City_____________________________________________ State _____________________ Zip__________
Phone Number___________________________________________________________________________
Date of Installation_____________________________ Spa Serial Number___________________________
Spa Model ______________________________________________________________________________
Your Dealers Name and Location_____________________________________________________________
What other spa brands did you consider buying?________________________________________________
Optional Questions
How many people are in your household?______________________________________________________
What is your age bracket? 25-30 31-40 41-50 51-60 61-70 71+
What is your reason for purchasing a spa? Health Benefits Stress Relief Relaxation
Other: __________________________________________________________________________________
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