Retail Warranty Card
Please fill out the form below. Fields marked with an astrisk(*) are required
Price Paid excluding tax
and installation costs
*Date of Purchase
Drinking Water – Faucet Mount
Drinking Water – Pitcher
Drinking Water – Refrigerator/Ice Maker
Drinking Water – Under Sink
Filtered Shower Head
Whole House Sediment
1. Is this your first Culligan purchase?
2. *Where this product was purchased?
3. Where do you intend to purchase replacement filters?
4. How did you first become aware of this product? (Choose one)
TV or Newspaper AD/Insert/Review
5. What influenced you most to buy a filter at this time? (Check all that apply)
To Improve taste
To eliminate odors
To reduce chemicals/impurities
Recent water quality concerns
Moved to new apt/home
6. What factors most influenced your decision to buy a Culligan brand product over another brand? (Check all that apply)
Received as gift
Previous experience with Culligan
Ease of installation
Value for the money
7. Who did (or will do) most of the work to install this product?
8. How easy or difficult was the installation of this product?
Unknown-installed by someone else
Please provide any feedback regarding the installation procedure:
9. What other brands did you seriously consider before making this purchase?
Tell us more about yourself
11. For your primary residence, do you:
Reside on college campus
Assisted Living Facility
12. Highest education level attained: (Choose one)
13. Would you be interested in receiving product information or special offers?
14. Would you be interested in receiving an email reminder to replace your filter?
15. Would you be interested in participating in a future research study?