Share FeedbackPlease share your experience with us by filling out this online form. Name * First Name Last Name Email * Phone Number * (###) ### #### Fax Number Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Product Name * When did you receive your product? MM DD YYYY What is your device's identifer? Please check off all device components that apply. Frame (REUFS-F1) Comfort Band (REUFS-CB1) Visor (REUFS-V1) Anti-Fog Spray Bottle (REUFS-AFS1) Other If you checked "Other" in the previous question, please fill in your device's identifier here. (You can find this unique series of letters/numbers in the user guide or on a white card provided in the product package.) Do you have any safety concerns with your product? * Yes No If yes, when did this problem happen? MM DD YYYY How long was this product in use? Please provide the nature and details of the problem. Additional Comments Thank you!
