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VITASMART COMPLAINT FORM - MEDICA SPA
Active Medical Device (AMD)
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Name (individual/company) *
E-mail address *
Phone
Country *
Third party complaint reference (if any)
Origin of the complaint - part 1
Hospital/Clinic
Distributor
Company
Organization
Clear selection
Origin of the complaint - part 2
Doctor
Paramedic
QC
Other
User
Clear selection
Other information regarding the Sender
Next
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