Special uses order

Please, fill the following form and a PSA Independent Distributor will be in contact with you shortly.

Name *

Phone *

Please, write your area code without adding any space or hyphen.

E-mail *

Address

District/Town *

Province *

Chosen Product *

For an optimal guidance, please let us know what type of water is consumed at your home

Running water

Untreated or of doubtful treatment water

Water issue to be treated *

Chlorine

Hardness/Scale

Suspended Solids

Cloudiness

In case you have another kind of water issue, please tell us

If you already are in contact with a PSA Independent Distributor, please, let us know his/her name

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