Form Requested as a Professional

Form Info Requested as a Professional

BruxApp Cloud is a platform in the medical health field and access is only allowed to doctors, dentists or physiotherapists.

For this reason, we need to collect your data and your professional qualification.

To do this, you must fill in the form on the side and send it.

Within 48 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 according to your needs.

Thank you for your interest.

First Name:

Last Name:

Email:

Country:

City:

Type professional:

District of registration:

Birth date:

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