Product(s) Purchased:

DS-3200 Humidifier
DS Classic
DS PowerPlus
Auto-Flush™ Unit
Enviro-Clean Descaler Solution
Hygrometer

Date of Purchase:

2008 2007 2006 2005 2004 January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Purchased From:

-- Select -- Canadian Tire High Q Products Just Humidifiers Lowe's Rona Professional Contractor

Or Other:

Salutation:

---- Mr. Ms. Mrs. Miss

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Install Date:

2008 2007 2006 2005 2004 January February March April May June July August September October November December 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Type of Installation:

Replaced an existing humidifier
Existing furnace without humidifier
New home or new furnace

Installed By:

Yourself
Home Builder
Plumber

Heating Contractor
Furnace Technician
Other

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Type Replaced:

Flow Through
Drum
Other

Replaced Brand:

How did you hear of our products? (check all that apply)

Referral
Advertisement
Trade Journal
Internet Search

Contractor/Plumber
Saw it in Store
Utility Company
Other

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