Cirrus Plus wheelchair Warranty Registration
Please type or print
Serial#__________________________________________Date Purchased___/___/___
Owner Name ___________________________________________________________
Address _______________________________________________________________
City ______________________________________State ________ Zip ____________
Additional Required Owner Information
Please indicate your understanding of your Cirrus Plus wheelchair by completing the following information.
_________ I have read and fully understand
__________ Owners Manual, especially sections on operating instructions,
safety guidelines, maintenance and battery instructions.
__________ Cirrus Plus wheelchair Warranty
Battery
_________ My dealer has instructed me on how to operate my Cirrus Plus wheelchair.
Signature ____________________________ Dealer Name _____________________
Telephone (___)_______________________ Dealer Phone (___)_________________
Comments ____________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
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