Dear new customer,
Unfortunately "JavaScript" is not activated in your browser, that is why our customer portal can not function or can not be displayed correctly. You have two possibilities:
- Activate JavaScript on your browser
- Send us the completed application form
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You can also download the application form, fill it in, sign it and send it to us by post, by fax or scanned by e-mail. If you wish a commencement of the contract as soon as possible, your contract commences when the application reaches us (e.g. with date and hour of the fax).
If you have any questions, you are welcome to call us on the phone.
Dialling +49 421 240110-15 you can reach us Monday to Friday between 8am and 5pm!
Your aqua med team
