REQUEST INFORMATION

Name Beauty Parlor or Institute

VAT-nr

Mr.Mrs./Ms.

Name*

Adress*

ZIP code + Town/City*

Telephone*

Website

E-mail adress

Where did you learn about this Medex-site*

By Medex newsThrough another siteThrough other means:

Are you a graduated Beauty Therapist?*

No, I'm a consumerYes, I'm graduated in the year:

Are you already a Medex Beauty Therapist?*

YesNo

Do you have a specific question e.g. about Medex products?

Please send me information regarding*

Medex Hand & Body CreamMedex Causaal DeodorantMedex ProfessionalMedex for MenQuintensteinPurus Acne treatmentXenymphus ThalassoCharlotte SophieJosephine van SteinborgSun With SenseSoftly Skin CareSoftly ShampooCosmetic MesotherapySerum Repair TherapyCure Therapy SeriesOther:

I want to register for the Medex Newsletter.

YesNo

I agree with the privacy statement.

Note that the fields marked * are required

Medex Germany

Client and Productioncentre
Hollandstrasse 1
49767 Hebelermeer

Medex The Netherlands

p/a Postbus 34
9430 AA Westerbork

Tel.: 0593 – 33 10 00
E-mail: info@medex.nl

Medex Belgium

p/a Square de Meeûs 38/40
1000 Brussels

Tel.: 02 588 50 97
E-mail: info@medex.eu

Opening hours

Monday: 08:30 – 17:00
Tuesday: 08:30 – 17:00
Wednesday: 08:30 – 17:00
Thursday: 08:30 – 17:00
Friday: 08:30 – 16:30

Medex

CoC: 04032591
VAT: DE293230618