Please complete the form below to activate your Lomak warranty. Note that all information you supply will only be used by Opdo Limited to support your use of their products, and will not be divulged to any third party except where there is a legal requirement to do so.

LOMAK Details

Keyboard serial number*
(found on the back of your keyboard above the word “lomak”)
Date purchased (dd.mm.yyyy)*
 
I have read the “Read Me First” section of the User Guide*
 

Customer Contact Details

Please provide a contact name if you are part of an organisation
Title (please choose one)
 
 
 
 
 
 
 
Family Name*
Given Name*
Organisation (if applicable)
Number and street*
Town or city*
Province or state*
Postal or Zip Code*
Country*
Your Email*
Do you wish to receive the Lomak e-Newsletter?

Retailer Details

Please provide sufficient detail for us to identify the retailer from whom you purchased your LOMAK
Name*
Town or City*
Country*

SECTION 2 (All fields are optional)

We would appreciate you filling in the section below to help us with our research, product development, and support both for you and for the wider community of LOMAK users. However, your warranty will be valid even if you do not fill in any of this section.
1) Which of the following best describes you as the owner of a LOMAK?
 
 
 
 
 
2) If you are an individual user or care giver, it would be helpful to know the type of disability that is the main reason for your use of a LOMAK, or if you are an organisation, the range of disabilities for which you cater. (Please tick the appropriate box(es) or provide separate information)
 
Arthritis
Multiple sclerosis
Carpal tunnel syndrome /Repetitive strain injury (or similar)
Muscular atrophy/dystrophy
Cerebral palsy
Stroke
Motor neurone disease
Tetraplegia/quadriplegia
Other
If other, please explain*
3) Which of the following best describes your current occupation?
 
 
 
 
4) What is your age?
 
 
 
 
 
 
 
 
5) How did you first hear about LOMAK?
Medical Practitioner
Conference/seminar
Magazine
Disability support group
Family/Friend
Internet
Retailer/Rental company
Newspaper
Other
Please provide details (e.g., retailer/rental company name)
 
6) Where did you first trial a LOMAK?
Disability resource centre (or similar)
Rental company
Retailer
At friend/family member’s home or workplace
Educational institute
Other
Please provide further details (e.g., name of centre/rental company etc.)
 
7) What were your principal reasons for choosing a LOMAK?
8) Any comments you think might help us to improve our service or products.