
	The Worldwide Leader in Handheld X-ray

Product Warranty Registration

Thank you for your purchase of the NOMAD® Handheld X-ray System. We value and appreciate your business.

Please fill out the form below to register your NOMAD device. We do not rent or sell your personal information to anyone.

Business/Organization Name
Phone Number (xxx)xxx-xxxx
Email Address
Contact Person
Street Address
City
Province
or U.S. State
Postal/Zip Code
Country
Type of Practice
Purchased From
Purchase Date
Information from the sticker on your registration form:
Mfg. Date
Model No.
Serial No.
Tube Assembly
Model No
Serial No.
Would you like information on our Total Care Plan service protection?	Yes No
Would you like product updates via email?	Yes No