Form Requested as a Professional

In order to use the BruxApp Cloud platform as a Class 1 Medical Device we must ensure that you are indeed a doctor, dentist or physiotherapist.

We must therefore verify your identity and registration with the Medical Association or the Register of Physiotherapists (FNOFI) of the province you belong to.

To do this, you must fill out the form opposite and send it.

Within 24 hours you will receive a confirmation email and a link to access all the necessary information and compare the subscription plans with the various opportunities reserved for you depending on your needs.

We thank you for your interest.

* indicates required
/ /( dd / mm / yyyy )

www.bruxapp.info

Puoi annullare l'iscrizione in qualsiasi momento facendo clic sul collegamento nel footer delle nostre e-mail. Per informazioni dettagliate sulla nostra Privacy policy vedi link sul nostro sito web. / You can unsubscribe at any time by clicking the link in the footer of our emails. For detail information about our privacy practices, please visit link on our website.

We use Mailchimp as our marketing platform. By clicking below to subscribe, you acknowledge that your information will be transferred to Mailchimp for processing. Learn more about Mailchimp's privacy practices.