Startseite New customer registration

New customer application form

New customer registration

New customer registration

New customer application form

Please complete the new customer application form in full. As soon as we have received your application, the responsible customer advisor will contact you.

 

    Your message (optional)

    When you submit your application, we will process the personal information you provide; we do this so our customer advisors can contact you and subsequently accept your application as applicable.

    Further information about our privacy policy can be found on our data protection page.

    You can also get in touch with us here: kundenbetreuung@medica.ch.

     

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