form: Product Registration (URAWA Product Users) - URAWA Corporation

form: Product Registration (URAWA Product Users)

    Company/Salon Name (*)

    Your Name (*)

    e-mail (*)

    e-mail (for confirmation)

    Phone

    Country (*)

    Your Product (*)
    UP200 seriesUP220 seriesSUP200 seriesUP200V seriesG3 seriesG5 seriesOthers

    Controller (*)
    Model Name:
    Serial Number:

    Handpiece (*)
    Model Name:
    Serial Number:

    (*): Input Required

    URAWA may share the above filled information to our distributors to provide customer a better service.
    Please push "SUBMIT" button only in case you agree it.