Hearing Aid Repair Lab
Established 1967
| Phone: 707-462-8211 Toll Free: 800-653-8882 Fax: 707-462-4858 email: info@lillielectronics.com |
168 Washington Ave |
Name
Address
City State Zip
Phone Date Email
Make Serial#
Please indicate how you found us. (Circle one) Returning Customer, Internet, Popular Mechanics,
Friend ( ) Other ( )
Describe problem with hearing aid, or request
Hearing aid batteries, 2 pack minimum. Each pack contains 4 batteries.
|
QTY |
Description |
Unit Price |
Sub Total |
| Hearing Aid Repair (Includes return shipping by "Priority Mail") |
$162.00 |
||
| Batteries Indicate size:________ (Free Shipping) |
$3.00 |
||
| "Same Day Service" (per hearing aid) | $21.00 | ||
| Shipping, for overnight delivery by DHL (per shipment) | $14.00 | ||
| Check or Money Order only (Sorry, no credit cards) |
Total Enclosed |
$ | |
Print this form. Complete it and include it with your hearing aid or battery order
Thank you !
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