Important Safety Information

Reply form

FSCA MMS2 2026-05.01_PSSUnnoticedLeak

Reply FSCA MMS2_2026-05.01_PSS Unnoticed Leak

Confirmation

I hereby confirm receipt of this letter and that I have read, understood and will implement its contents. This letter has been brought to the attention of all users of the product and of other people in my organization who need to be informed. If the products have been passed on to third parties (applies to specialist dealers, for example), a copy of this information has been passed on to them.

Personal details

Customer no.

Address

Contact Person

Email address

Other reply

I am no longer in possession of the medical device.

The new owner is (company + address)

We have disposed of the following medical devices.

Enter name of medical device incl. serial number

Data protection

I hereby consent to the processing of my personal data. I have taken note of the privacy policy.