Warranty Registration

The Midwest Warranty Registration couldn't be simpler; we do the work for you.

Most hearing devices come with a Manufacturer's Warranty that covers hearing devices from 1 - 3 years. Once the Warranty expires, the cost to replace and repair that device becomes the responsibility of the individual. Midwest's Warranty Registration offers individuals a way to be notified when their manufacturer's warranty is set to expire, providing information and an offer for coverage should you want to extend.

Please send me a notice to continue my loss and damage coverage for the hearing instrument described below. This coverage will take effect on the expiration date of the manufacturer's warranty for loss and damage coverage.

CONTACT INFORMATION

First Name:

Last Name:

Address 1:

Address 2:

City:

State:

Postal Code:

Is this a change of address?

Phone:

E-mail Address:

WARRANTY INFORMATION (all fields are required)

Manufacturer:

Model:

Style:

Date of Purchase:

Left Device - Serial Number:

Right Device - Serial Number:

Loss & Damage Expiration Date:

Office/Clinic Name:

Denotes required fields