Trade in request

1. State *

2. Email address of the person raising the trade in *

3. Full name of the person raising the trade in *

4. Which of the following are you considered to be ? *

Please select one of the following:

Distributor

Health care professional

Student

5. Your organisation/ company name *

6. Address line 1 (no PO boxes please) *

7. Address line 2

8. City *

9. Zip code *

My shipping address is different than company address

10. Phone number *

11. Product being traded in *

12. Customer account number

if known?

13. Product purchased *

14. Date of purchase *

• Important! Keeler cannot be held responsible for equipment that is damaged or lost in shipping.
Therefore, we strongly advise that you follow these instructions carefully.

• Instructions

Please complete the form above and click 'Submit Form'.
Select a carrier that provides tracking information for the package.
Securely pack and ship the product.
Please use either UPS or Federal Express to send the package back to us.

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