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Product(Required)

Serial number* (*can be found on the product label under dentist element)(Required)

Date of installation* (*Warranty runs from this date or from the 91st day after the day of leaving the factory, whichever comes first)(Required)

Name of dental practice owner*(Required)

Email of dental practice owner*(Required)

Company name of the dental dealer installing the dental unit*(Required)

Name of technician installing the dental unit (optional)

How many years of warranty did you order?

Additional info (optional)

GDPR authorization: I confirm the registration of my unit and accept that my contact details could be used for communications and marketing purposes. Attn!: One form is valid for one product. Please submit this form for each product installed in your practice.(Required)

I agree