Warranty Claim

Warranty Claim Form

Clinic Name(Required)

Name(Required)

Email(Required)

Phone(Required)

Select Type of Controller

2 Port Controller

6 Port Controller

Choose Types of Therapy Pads, Boots or Brain Cap Purchased

Thigh High 442 Boots

Calf Half 364 Boots

Lumbar Pad 480

Brain Cap 280

Description of Issues you are Experiencing(Required)

Order Number(Required)

Date of Purchase(Required)

Return Label?(Required)

Ship to Address(Required)

Street Address Address Line 2 City State ZIP Code

How many states are in the United States of America?(Required)

Name

This field is for validation purposes and should be left unchanged.

Disclaimer: Light therapy devices are not intended to diagnose, treat, cure or prevent any disease. The information contained on this website is for educational purposes only. This medical device is not intended to be a substitute for medical advice. Please consult your Doctor for any and all medical advice. Disclaimer: Statements contained herein have not been evaluated by the FDA.

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