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# 1318
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 Main Frame
02 Front Stabilizer
03 Rear Stabilizer
04 Front Post Ø60x2.0tx975mm
05 Handlebar Ø32
06L Upper Left Handrail Ø32
06R Upper Right Handrail Ø32
07L Left Handrail Arm Ø32
07R Right Handrail Arm Ø32
08 U shape Bracket
09L Left Foot Bar
09R Right Foot Bar
10 Crank
100 Adaptor
101 Bottle Holder
102 Console
103 Screw
109 Hexagon Socket Head Bolt M8x15mm
115 5mm Allen Wrench
116 Multi-Hex Tool with Phillips Screwdriver
12 Console Wire L=1050mm
13A Front Cover
13B Rear Cover
15 Extension Sensor Wire L=1250mm
17 Hand Pulse Sensor Wire L=750mm
18 Washer Ø8xØ21x2.0T
22L Left Foot Pedal
22R Right Foot Pedal
23A Lower Crank Cover A
23B Lower Crank Cover B
32 Hexagon Socket Head Bolt M8x15mm
33 Pan Head Screw
34 Carriage Bolt M8x70mm
35 Cap Nut M8
36 Washer Ø8xØ16x1.5T
38 Curve Washer Ø21xØ8x2t
39 Hexagon Socket Head Bolt M8x45mm
40 Nylon Locknut M8
41 Hexagon Socket Head Bolt M10x80mm
42 Washer Ø10xØ19x1.5t
43 Carriage Bolt M6x45mm
44 Nylon Locknut M10
45 Nylon Locknut M6
46 Washer Ø6xØ14x1.0t
50 Plastic Bushing Ø19xØ38x64mm
51 Washer Ø19.5xØ38x0.5T
53 Hexagon Socket Head Bolt M8x18mm
58A Front Handrail Arm Cover
58B Rear Handrail Arm Cover
59 Round Head Self Tapping Screw M4.5x15mm
70 Wave Washer Ø16.2xØ25x0.5t
71 Washer Ø8xØ25x2.0T
75A Foot Bar Cover-A
75B Foot Bar Cover-B
80 Spring washer 8mm
97A U-Shape Bracket Cover A
97B U-Shape Bracket Cover B
99 Power Jack
HW Hardware Pack
 

"YOUR ORDER WILL BE PROCESSED WITHIN 3 BUSINESS DAYS"

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