Register a new account
Step 2 of 3
Additional addresses and contacts
Delivery Adress
This information is essential for the courier when delivering sampling material sets. Edit the address if necessary.
| Hospital / Clinic / Private practice | |
| Department | |
| Address Line 1 | |
| Address Line 2 | |
| Post code | |
| City | |
| Country |
Delivery contact person
It is essential for the courier to have a contact person when delivering the sampling material sets. Edit the contact person if needed.
| Title and Name | |
| Phone |
Sample Pick-up address
This information is essential for the courier when picking up samples. Edit the address if necessary.
| Hospital / Clinic / Private practice | |
| Department | |
| Address Line 1 | |
| Address Line 2 | |
| Post code | |
| City | |
| Country |
Sample Pick-up contact person
It is essential for the courier to have a contact person when picking up the samples. Edit the contact person if needed.
| Title and Name | |
| Phone |
Register new user
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