Registration of the implanted prosthesis

Company “NeoCor” is engaged in registration of the patients with the implanted prosthesis, manufactured by the Company. After registration the patient is given a plastic card. It is recommended to carry it around with you at all times. The card contains information which can be useful for you and your attending physician.

The information submitted for registration, stored in the Patient Registration System, is considered confidential and is not subject to disclosure. It is important to update this information in proper time. If you have implanted prosthesis and you move to a new place or change the doctor, please notify us, so that we can introduce the respective information into the register.

Registration and updating of the information is made free of charge.

To register the implanted prosthesis please fill in the form below:

Surname, first name, patronymic *

Date of birth *

Address

Phone number

E-mail *

Information about implanted medical item:

Implanted item

Serial number

Date of operation

Where did implantation take place ( city, town, medical institution)

Surname, first name, patronymic of the surgeon conducting operation

Surname, first name, patronymic of the attending doctor

Confirm your consent for personal data processing *

I give consent for processing of my personal data

User Agreement

Notes

CJSC NeoCor, OGRN 1024200695991, address: 6 Sosnovy boulevard, Kemerovo, 650002, Russia