Implants of Excellence

Personal Information
(*) is mandatory
You will receive your registration documents by e-mail. Please tick box below to receive the documents by regular mail
- I would like to receive my documents by regular mail
  I understand this can take up to 6 months.
- Last Name*
- First name*
- Street Name*
- House Number*
- Postal code*
- City*
- Country*
- Date of Birth*
  DD dot MM dot YYYY

General Implant Details
(*) is mandatory
- REF and SN numbers found in your POLYTECH Implant Passport – provided to you by your surgeon after your surgery.
- Implantation date*
  DD dot MM dot YYYY
You can register your implants only once. If you have a left and a right implant. You need to register both implants together in one form.
Breast REF/SN Numbers
- Left
- REF implant reference number/s*
- SN implant serial number/s*
- Right
- REF implant reference number/s*
- SN implant serial number/s*
Gluteal REF/SN Numbers
- Left
- 1. REF implant reference number/s*
- 1. SN implant serial number/s*
- 2. REF implant reference number/s*
- 2. SN implant serial number/s*
- 3. REF implant reference number/s*
- 3. SN implant serial number/s*
- 4. REF implant reference number/s*
- 4. SN implant serial number/s*
- Right
- 1. REF implant reference number/s*
- 1. SN implant serial number/s*
- 2. REF implant reference number/s*
- 2. SN implant serial number/s*
- 3. REF implant reference number/s*
- 3. SN implant serial number/s*
- 4. REF implant reference number/s*
- 4. SN implant serial number/s*

Completion
(*) is mandatory
Agreement to the online registration*
- I have read the information brochure on the extended warranty program “Implants of Excellence” and I herewith personally register for this program and agree to the terms. POLYTECH Health & Aesthetics GmbH is obliged to treat personal data as strictly confidential. All data will exclusively be used for statistical analysis. POLYTECH Health & Aesthetics GmbH reserves the right of publication of the statistical analysis.
Please notice our Data Policy on our website.

https://polytech-health-aesthetics.com/en/contact/privacy-policy
Terms and Conditions*
- I have read the terms and conditions
Terms and Conditions
Hidden
I accept the online registration.*
- I accept the online registration.
Please type in your E-mail address and click on “Verify E-Mail”

Make sure to provide a valid E-Mail address

You will receive an E-Mail with a “One-Time-Password” afterwards. Type in the OTP in the “E-Mail-Verification” field to verify your E-Mail address. The verification process is needed to improve data protection for your personal data in this form.
Email*

After sending you the documents via regular mail, we will contact you exclusively per E-Mail.
Verification Code

Type in the Verification Code sent to the E-Mail you provided and click the “Send” button.If you don’t receive the code, be sure to check your Spam folder.
Name
This field is for validation purposes and should be left unchanged.

Registration Form