Invacare New Zealand Product Registration Form

A few minutes well spent...
It's not everyday that a few minutes of your time brings about years of benefits. Register your product and receive:

Product updates
Support alerts
Personalised service
Newsletters

Promotional offers
Fast technical support
PLUS a free t-shirt! (manual and power wheelchairs only)

Some information is compulsory as this is the bare minimum information we need to be able to process your product registration. Other fields such as 'Disability' and "Birthdate' are entirely up to you and are there to help us tailor our communication to you. Invacare values your privacy; click here for Invacare's full policy on this.

Your Information

Title
First Name
Surname
Address
Suburb
Town/City
Post Code
NZ Post Code finder
Phone Number
Email

Product Information

Find this information in your Welcome Pack or documentation that came with your Invacare product

Purchase Date
Product Range
Product Model/Name
Serial Number
Funding If Other, please specify
Organisation product supplied by

A bit more about you

Not mandatory, but if you are registering a manual or power wheelchair we will need your t-shirt size to send you a free one.

Disability
Date of Birth
Preferred t-shirt size

Final information required

How did you hear about
Invacare
Preferred method of contact
I do not wish to receive further correspondence from Invacare

Location http://www.invacare.co.nz/index.cfm/0,77,961,html