Please complete and submit the following form to validate your product warranty. Please use a separate form for each model type.
Contact Information:Company NameContact NameAddressCityState/ProvinceZip/PCPhoneFaxEmailType of BusinessWater/Fire Damage Restoration Carpet/Rug Cleaning Carpet Cleaning & Water Damage Restoration IAQ/Environmental Services Janitorial/Sanitation Construction Rental Store Pet Grooming/Boarding/Veterinary Services Inflatables Other (please specify) If you selected other, please specify:Number of Employees1-6 7-12 13 or more Years in Industry1-4 5-10 11-19 20 or more Purchase InformationDate of PurchaseFormat: YYYY-MM-DDModelSerial Number(s)Purchased FromWhere did you learn about this product? (select all that apply)Distributor Magazine ad Trade show Website Direct mail Word of mouth Other (please specify) If you selected other, please specify:What prompted you to purchase this product? (select all that apply)Distributor special ASD/WRT class Trade show Seasonal purchase Needed for a specific job Other (please specify) If you selected other, please specify:What other brands did you consider when making your purchase decision? (select all that apply)DryAir Technology Phoenix Abatement Technologies Mytee Powr-Flite Other (please specify) If you selected other, please specify:What other equipment do you plan to purchase in the next 6 months?Refrigerant dehumidifiers Desiccant dehumidifiers Airmovers Air scrubbers Large heat-air exchange drying unit Other (please specify) If you selected other, please specify:Please rate your satisfaction with your distributor: Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied Product demonstration Product demonstration Very satisfiedProduct demonstration SatisfiedProduct demonstration NeutralProduct demonstration DissatisfiedProduct demonstration Very dissatisfiedProduct knowledge Product knowledge Very satisfiedProduct knowledge SatisfiedProduct knowledge NeutralProduct knowledge DissatisfiedProduct knowledge Very dissatisfiedProduct availability Product availability Very satisfiedProduct availability SatisfiedProduct availability NeutralProduct availability DissatisfiedProduct availability Very dissatisfiedDri-Eaz product display Dri-Eaz product display Very satisfiedDri-Eaz product display SatisfiedDri-Eaz product display NeutralDri-Eaz product display DissatisfiedDri-Eaz product display Very dissatisfiedPayment terms offered Payment terms offered Very satisfiedPayment terms offered SatisfiedPayment terms offered NeutralPayment terms offered DissatisfiedPayment terms offered Very dissatisfiedFriendliness of staff/customer service Friendliness of staff/customer service Very satisfiedFriendliness of staff/customer service SatisfiedFriendliness of staff/customer service NeutralFriendliness of staff/customer service DissatisfiedFriendliness of staff/customer service Very dissatisfiedCleanliness of facility Cleanliness of facility Very satisfiedCleanliness of facility SatisfiedCleanliness of facility NeutralCleanliness of facility DissatisfiedCleanliness of facility Very dissatisfiedPlease rate your satisfaction with Dri-Eaz: Very satisfied Satisfied Neutral Dissatisfied Very dissatisfied Customer service Customer service Very satisfiedCustomer service SatisfiedCustomer service NeutralCustomer service DissatisfiedCustomer service Very dissatisfiedProduct performance Product performance Very satisfiedProduct performance SatisfiedProduct performance NeutralProduct performance DissatisfiedProduct performance Very dissatisfiedProduct availability Product availability Very satisfiedProduct availability SatisfiedProduct availability NeutralProduct availability DissatisfiedProduct availability Very dissatisfiedEducational support Educational support Very satisfiedEducational support SatisfiedEducational support NeutralEducational support DissatisfiedEducational support Very dissatisfiedAdditional Comments/Suggestions:
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