Referral Form

Congratulations on your recent purchase from Dr. Johns H2O, we are honored that you chose us for your water treatment needs. We trust you are happy with the quality and performance of your new Kinetico water treatment system.

We believe that word of mouth is the best form of advertising, and who better to talk about the product than YOU. Tell your friends and family about your experience with Dr. Johns H2O, and have them contact us today for a free water analysis or fill out the form below. Should they decide to have a system installed by Dr. Johns H20, we will gladly send you a token of our appreciation for the kind referral. You could receive up to $100 per referral depending on what type of system is installed.

Your information:

Name:
Address:
Phone Number:
Email Address:

New Referral Information:

Name:
Phone Number:
Email Address: