customer portal registration request - Canon Medical 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

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Keeping in touch via:*

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I understand that my contact details provided in this form will be used to contact me regarding my inquiry / registration for the above event. To learn more, see Canon Medical's Privacy Policy.

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I agree to receive marketing related electronic communications about Canon Medical's products, services, events and promotions that may be relevant to me.

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