First Name*  
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Last Name*  
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Email*  
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Phone Number*  
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Please provide your phone number in case we need to contact you.
 
Country*  
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Address*  
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Address 2  
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City*  
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Zip*  
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State*  
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Order Number*  
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This number can be found on the letter you may have received from Lutron or by reviewing
the label information diagrams above.
 
Where did you purchase your shade?*  
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When did you purchase your shade?*  
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Who installed your shade?*  
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How many Serena and/or Sivoia QS Triathlon shades do you have?*  
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How many of these shades mounted on a door? *  
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Do you have any shades at risk of an external impact from the front, such as an impact from being struck by a door or a firmly thrown ball?*
(*see illustration below)
 
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Do you have any shades at risk of an external impact that would lift the roller tube from below and simultaneously pull it outward?*  
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