Only the management or the purchasing departments partly hospitals they can request the pieces directly through this form. We will get back to you as soon as possible. See the statement for hospitals, companies and individuals before filling out the form, or go to catalog to see the pieces that you can request.

    Applicant hospital

    Address

    Postal code

    Population

    E-mail

    Telephone

    The piece you want ...

    Reference of the piece

    Describe us the piece and the need

    How many units?

    Attach a photo (max. 1MB)Optional

    Comments Optional

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