Helix Registration - Helix Lateral Trainer

HELIX REGISTRATION

Helix Serial Number *

(Located under the Helix Dome Cover and on the outer box)

Date Purchased *

Contact Name *

Company Name (If applicable) *

Contact Email *

A valid email address MUST be provided to confirm your registration & support future service claims. This address will be secured by Helix and never used for any other purpose.

Contact Phone *

Address *

Apt, suite, etc.

Country

City

State

Zip code

Purchased From *

Salesperson (If applicable) *

Installed by (check one) *

Installation Company

Self-installed

Installation Company (If applicable) *

Comments *

Please leave any comments & we\'ll be sure to get back to you asap

Captcha *

reCAPTCHA is required.