Paradigm Health & Wellness, Inc.
EMAIL THIS FORM WITH YOUR RECIEPT OF PURCHASE TO
Service@paradigmhw.com
*
NAME: _______________________________________________________
ADDRESS: ____________________________________________________
CITY ______________ STATE ______________ ZIP ___________________
TELEPHONE: (Day) ____________________________________________
(Night) ____________________________________________
SERIAL#: _____________________________________________________
MODEL#: _____________________________________________________
PURCHASE DATE: _____________________________________________
PLACE OF PURCHASE: _________________________________________
“YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS”
* This form can also be faxed in Fax #: 626-810-2166
PART #
DESCRIPTION
QTY
PART
REQUEST
FORM
29
Summary of Contents for 6871.1-122915
Page 2: ......
Page 8: ...OVERVIEW DRAWING 6 ...
Page 9: ...7 OVERVIEW DRAWING ...
Page 10: ...HARDWARE PACK 8 ...
Page 13: ...11 ...
Page 27: ...STEP 7 25 NO 120 Round Cap D25 4xD65x31 5 4PCS ...