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
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