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Please complete one form for all units of the same model being registered.

Date of Purchase:
Please select month.Purchase month required. Please select year.Purchase year required.
Quantity Purchased:
  Quantity purchased required.
Model Number:
  Model Number is required.
Lot Number: Lot Number Explanation   Lot Number required.Use format MM/YR. Code required./ Code required. Please select an extended code is applicable, or N/A.Please select extended code or N/A if not presen
Purchase Price:
Purchase price range required.
User's Age Range :
 
Prefix:
 
First Name:
  First Name is required.
Last Name:
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Organization:
 
Suffix:
 
Address:
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Address 2:
 
City:
  City is required.
State/Province:
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Zipcode/Postal Code:
  A 5-digit zipcode or 6-character Postal Code is required.5-digit zipcode required.Minimum number of characters not met.Exceeded maximum number of characters.
Country:
  Country is required.
Phone:
  Invalid format. Phone number format (xxx)xxx-xxxx.
Email Address:
  Invalid format.Valid E-mail address is required.

Where did you purchase your TherabathPRO?
Where purchased:
  Please select where the unit was purchased.Where purchased is required.
Store/Seller Name:
  Store or seller name required.
(Note: If purchased from Amazon.com, indicate the seller name.)
City:
 
State/Province:
 
Country:
 

Additional Comments?
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Please indicate whether you would like our FREE gift for registering.
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WR Medical Electronics Co. 1700 Gervais Avenue, Maplewood, MN 55109 USA.
Toll-free 800-321-6387; phone 651-604-8400; fax 651-604-8499. Hours: M-F, 8:00 am to 4:30 pm Central Time.

All content copyright 1998-2017 by WR Medical Electronics Co. All rights reserved. For trademark and patent information, please go to our legal notices page,
or for returns or our Privacy Policy go to our Returns/Privacy Page.
Last modified:October 3, 2017.

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