Paradigm Health & Wellness, Inc.

PARTS REQUEST FORM

NAME:*

Please input name.
PURCHASER'S NAME:*
   Same as Name.
Please input purchase name.
ADDRESS:*

Please input address.
Apt.#:

Please input Apt.#.
CITY*

Please input city.
STATE*

Please input state.
ZIP*

Please input zip code.
TELEPHONE: (Day)*

Please input telephone number.
(Night)
(Email Address)*

Please input email address. Example: service@paradigmhw.com
SERIAL#*

Please input serial number.
MODEL# 1111
PURCHASE DATE:
Format: mm/dd/yyyy
PURCHASE FROM:
Please provide a copy of Proof of Purchase (e.g. invoice):*   
Please select file for upload.
     I do not have Proof of Purchase but I have registered the product online.
COMMENTS:
PART# DESCRIPTION QTY
01 Back and Seat Support Bracket 53x23x2.0
02 Front Stabilizer Ø60x1.5x380
03 Rear Main Frame
04 Rear Stabilizer Ø60x1.5x480
05 Front Main Frame 80x40x2
06 Front Handlebar Post Ø50x1.5
07 Seat Cushion
08 Back Cushion
09 Computer (JVT29121)
10 Handlebar Foam Grip Ø30xØ24x510
11 Hand Pulse Sensor
12 Round End Cap for Handlebar Ø25x1.5
13 Handlebar Ø25x1.5
14 Tension Control Knob
15 Seat Sliding Tube 23x53x1.5
16 Left Cover Cap Ø60xØ24x2
17 Round Knob M16x1.5
18 Right Cover Cap Ø60xØ24x2
19 Front Handlebar Foam Grip Ø30xØ24x160
20 Nylon Nut M8
21 Bolt M6x15
22 Backrest and Seat Support Bracket End Cap 23x53x1.5
23 Bolt M8x15
24 Washer Ø8
25 Curve Washer Ø8
26 Screw ST4.2x20
27 Wire Plug Ø12.1
28 Bolt M8x18
29 Locknut M6
30 Bolt M8x70
31 Spring
32 Cap Nut M8
33 Left Cover
34 Right Cover
35 Screw ST4.2x25
36 Bolt M5x25
37 Adjustable Bolt M6x33
38 Big Curve Washer Ø5
39 Bolt M5x10
40 Tension Cable L=1000mm
41 Axle Bush
42 Bearing
43 Axle Sleeve I 15/16"
44 Nut 7/8"
45 Washer Ø34.5xØ23x25
46 Crank Ø200
47 Flywheel Ø230
48 Idle Wheel Bracket
49 Bolt M8x30
50 Front Stabilizer End Cap Ø60
51 Transport Wheel Ø23xØ6x32
52 Nut M6
53 Nut M10x1
54 Bushing
55 Middle Section Hand Pulse Sensor Wire
56 Idle Wheel
57 Rear Stabilizer End Cap Ø60
58 Washer Ø6
59 Right Foot Pedal YH-30X
60 Left Foot Pedal YH-30X
61 Sensor with Wire L=500mm
62 Belt 340J6
63 Extension Wire L=350mm
64 Extension Sensor Wire L=350mm
65 Extension Hand Pulse Sensor Wire L=1800mm
66 Triangle Knob M12x27
67 Pan Head Phillips Self Drilling Screw ST4.2x15
68 Hand Pulse Sensor Wire L=650mm
69 Pan Head Phillips Self Drilling Screw ST4.2x25
70 Bolt M8x45
71 Bolt M6x48
72 Axle Sleeve II
73 Washer 7/8"
74 Front Handlebar Post Cover
75 Right Rear Main Frame Cover
76 Left Rear Main Frame Cover
78 U Bracket
79 Spring Washer Ø6
80 Clip
81 Knob M16x1.5
82 Phillips Self-Tapping Screw ST4.2x6
83 Hex Screw M6x8
84 Baffle Plate
HW Hardware pack
 

"YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS"

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