Register Your Product

Thank you for your purchase of this product.

You can help us to continue providing you with the finest products available by completing and submitting this brief questionnaire. This information enables us to improve existing products, develop new products, and reach our customers more efficiently. Returning this form will allow us to contact you regarding this product should the need arise. We appreciate your help, and thank you for your cooperation.

Required fields are indicated with *

Languages:

French

Spanish

About You*denotes a required field

Your date of birth:

How many - including yourself - are in your household?

For your primary residence, do you:

About Your Product

Where do I find the UPC?

(If the manufacturer's code does not appear on the UPC code shown above, please look for a small label inside the toilet tank that will give you this information.)
Date of manufacture:
(K,G, or T)
Date of purchase: *

About Your Purchase

Which one of the following best describes what prompted your purchase?
(years old)
[rating on a 1 to 10 scale - 1 Not at all satisfied / 10 extremely satisfied]
[rating on a 1 to 10 scale - 1 Not at all likely / 10 extremely likely]
[rating on a 1 to 10 scale - 1 extremely difficult / 10 extremely easy]
In which bathroom is your new Delta toilet installed?
What other items did you purchase for your bathroom, if any, at the same time as your Delta toilet? Please select all that apply, and indicate if it was a Delta and/or another brand:
Major Fixtures
 
Delta
Other
Toilet
Urinal
Bidet
Bathroom Cabinet
Countertop
Vanity with sink top
Vanity without sink
Bathroom Sink
Faucets
 
Delta
Other
Bathroom Sink Faucet
Standard Bath Tub Faucet
Roman Tub Faucet
Shower Valves
Fixed Showerheads (non-hand shower)
Hand shower
Body sprays
General Products
 
Delta
Other
Flooring
Paint
Tile - For shower
Tile - For sink
Accessories
 
Delta
Other
Bathroom Accessories (such as towel racks, robe hooks, tooth brush holder, soap dish, etc.)
Bathroom Hardware (such as door knobs, cabinet handles, etc.)
Please indicate where applicable. (leave blank if not applicable)
 
Had the most influence in selecting the style
Had the most influence in selecting the brand
Actually purchased the toilet at the store
Installed the product
Both male and female household heads
Male household head
Female household head
Plumber/General Contractor
Decorator/Designer
Builder
Friend or Other Family Member
Local Handyman
Other
Do you plan to remodel any of the following areas in the next 12 months?
 
Yes
No
Don't Know
Kitchen
Master Bathroom
Laundry
Other Bathroom
What other brands did you consider before purchasing a Delta toilet? Choose all that apply:

Your Contact Preferences