Fill-up this form to receive your free trial kit. If need be, feel free to reach out to Julien +1 514-662-8228 / [email protected].

What are the dimensions of your favorite cassette (including hinges and screws)? This information is required to send you the right pouch size. *

What is the brand of your favorite cassette?

Do you have a regular washing machine in your clinic? It is required to wash the reusable pouch between each sterilization cycle. *

Yes / Oui

No / Non

How many patient rooms do you have in your clinic? *

Please confirm your details to receive your free trial kit (subject to stock availability)

Your title/role *

Clinic name *

Address

Street Address

City

Province

Country

Postal Code

Do you have any comment?