Simple and fast registration and connection, in complete safety

To obtain your access to the Reservation , do not forget to send your prescription after your registration.

Registration

Email*

Password*

Society

Title*

Name*

First Name*

Date of birth*
,

I am a professional

Address + Street number*

Postcode*

Town*

Country*

Mobile phone*

Name of prescribing physician*

Choose a prescription*

To take a photo of your prescription, click on the button above "Choose file" / "Browse".
You can attach an image, pdf, or zip document.