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HomeHuman ProductsRegister Your Product
Products - Register Your Human Product(s)

Other product registration forms ...
Equine Products  |  Canine Products

SPECTRA THERAPY, LLC.
5832 Glasgow Drive
Troy, MI 48085

If you fail to complete the product registration form below, your warranty rights as otherwise specified will not be diminished.


Please visit http://spectratherapy.com/privacy/ for privacy policy.

Product Registration Form

Name:*
E-mail:*
Phone:*
-
Address:*
Purchased Spectra Therapy Products (Check all that apply):*
Other accessories or products purchased that are not listed above:
Number of Lasers:*
Model: (Check all that apply)*
Other Models:
Serial Number(s) (Place comma's between each serial number if more than one):*
Purchased Date:*
Purchased from?*
Sales Contact (ENTER NAME):
How did you hear about Wearable LASERwrap®? (Check all that apply)*
Other:
About You
Your Gender:*
Age Range:*
Are you a healthcare professional?:*
If you answered "Yes" to healthcare professional, enter your specialty:
Occupation/Profession (Check all that apply):
Other Occupation/Profession:
Company Name (If applicable):
Company Address:
Work Phone:*
-
Work E-mail:
Website:
Number of other healthcare professionals are in your office? :*
About your purchase
Do you own other therapy devices?*
If yes to the previous question, please list the devices or technologies that you own or use:
What were the most important reasons you purchased Spectra Therapy LASERwrap®? (Check all that apply)*
If you checked "Injury","Chronic conditions", or "other" to the prvious question, can you please explain in further detail?
Why did you purchase a Spectra Therapy LASERwrap® kit over other therapy devices? (Check all that apply)*
If you selected "Other" to the previous question, plesae explain in further detail:
Are you interested in receiving information about extended warranty and protection plans?*
Do you want to receive product announcements?*
Do you want to receive information on special promotions?*
Are you interested in learning about becoming a distributor and/or offering the Spectra products for sale in your office or business?*
Recaptcha Word Verification:

Spectra Therapy

Troy, MI 48085
Phone: 248-524-6300

Email: info@spectratherapy.com

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