customer portal registration request - Canon Medical Systems Switzerland

MYCANONMEDICAL REGISTRATION

Please use this form to request registration to the MyCanonMedical portal. Once approved, you will receive access to the portal and its functionalities as configured by your organization's administrator.

Salutation*

First Name*

Second Name

Last Name*

Job Title*

Company*

Department*

Country*

Email*

Phone

Additional comments

Keeping in touch via:*

E-mail
Phone

Untitled*

By submitting this form, you agree that we may use the data provided to contact you with information related to your inquiry regarding Canon Medical products and services. If you already are a Canon Medical Customer, you can control your consent settings in the Canon Medical Portal. To learn more, see Canon Medical's Privacy Policy. Please only click the Submit button once.

CAPTCHA

Comments

This field is for validation purposes and should be left unchanged.