Partners In Care Service Agreement Activation

Please fill out the following information to activate your new Welch Allyn Partners in Care Service Agreement.

If your language (country) is not shown, please proceed to complete the form on this page.

Contact Information - Step 1 of 2

* indicates required fields

First Name:*

Address:*

Last Name:*

Address 2:

Organization:*

Country:*

Job Function/Position:

City:*

Email Address:*

State/Region:

Zip/Postal Code:*

Confirm Email Address:*

Phone:*

Fax:

Product Group:

Choose the product group that matches the device you are registering.

Reference Number:

Located on the back of your card in the above bar code.

Software Serial Number:

Located on the disc cover or found after opening Cardio Perfect Program by selecting HELP -> INFORMATION -> REGISTRATION.

Device Serial Number:

Your device number can be found on the device label. This is located on the product, or consult your user manual for the proper location.

Purchase Date:

Partners in Care Service: This should be the actual date of purchase of your Partners in Care Program. It may not be the same as your device.

Standard Warranty: This is the actual date of purchase of your device.

Extended Warranty: This is the actual date of purchase of your device.

Preventive Program: This is the actual date of purchase of your Preventive Program. It may not be the same as your device.

Probe Serial Number:

Located on Probe label.

Priority Number:

Located on the front of your Partners in Care Services Support Agreement Activation Card.

[X]

Product Group: (?)