P4X Inc. Product Registration Form
All information provided is for P4X Inc. use only.
Instructions
Please answer all questions to the best of your ability. All required field are marked by (*). When finished, submit the form by clicking the "submit" button on the bottom left-hand side of the page. Thank you.
Why should I register my PER4MAX wheelchair?
We recommend that you register to safeguard your investment and to ensure maintenance of your wheelchair that is within warranty guidelines. Please refer to your Owners Manuel for all warranty information. Registering also allows you receive updates regarding product information. It helps us serve you more quickly and efficiently by allowing us to contact you or your provider if maintenance is needed on your wheelchair.
P4X Inc.
1000 Post & Paddock Road Grand Prairie, TX 75050 Suite 310 (972) 641-6773
Full Name *
Email *
Address *
Phone number *
Phone number type *
Required
City *
State/Province *
Zip/Postal Code *
Product Serial Number *
PER4MAX Model Name (see Owners Manuel if necessary ) *
Required
Purchased From *
Date Purchased *
MM
/
DD
/
YYYY
Purchasing Method (Please check all applicable answers) *
Required
Submit
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