Product Registration

Please register your product below to activate your warranty. Your warranty will run from the date of the invoice not the date of registration. Please make sure to upload your purchase invoice.

Personal Information

Name

Company Owners Name

Company

Phone Number

Address

Address2

City

State

Zip Code

Product Category

Binocular Indirects

Binocular Unit

BIO Quantity

Headset Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Docking Station Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Docking Station Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Docking Station Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Battery Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Charger Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Cryo

Cryo Products

Unit Quantity

Unit Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase probes?

Yes

Purchased Probes

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase a second type of probe?

Yes

Second Purchased Probe

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase a third type of probe?

Yes

Third Purchased Probe

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Pachymeters

Pachymeter Unit

Pachymeter Unit Quantity

Pachymeter Unit Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Slit Lamps

Slit Lamp Unit

Slit Lamp Unit Quantity

Slit Lamp Unit Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Tonometers

Tonometer Unit

Tonometer Unit Quantity

Tonometer Unit Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Ultrasound

Ultrasound Unit

Ultrasound Unit Quantity

Ultrasound Unit Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase probes?

Yes

Purchased Probes

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase a second type of probe?

Yes

Second Purchased Probes

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase a third type of probe?

Yes

Third Purchased Probes

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Did you purchase a fourth type of probe?

Yes

Fourth Purchased Probes

Purchased Probe

Probe Quantity

Probe Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Diagnostic Hand Instruments

Hand Held Unit

Hand Held Unit Quantity

Surgical Loupes & Lights

Loupes and/or Lights

Unit Quantity

Working Distance

Did you purchase a sport frame?

Yes

Frame Size

Frame Color

Battery & Charger Serial Number(s)

Please list all serial numbers if you have more than one quantity. Please separate with commas.

Upload all invoices for products registered on this form

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Invoice Date

Invoice Number

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