Membership Application Maxxfaxx
Departments / Surgeons
Membership Application
Legal information
Specialists / Institutions
*
Institute name
*
Maxillofacial Surgeon in Charge
Qualification
*
Date
City/University
Country
Association/College/Affiliation
Hospital association
Spectrum
Implant types
Bone grafts
Facial Surgery
Aesthetic Surgery
Reconstructive Surgery
Orthognatic Surgery
Tooth removal
Apicoectomies
Alloplastic implants
Medical insurance
Payment modalities
Cash
Mastercard
Visa
External
Website
Image upload (jpg, gif, png, pdf)
Security question
*
Please calculate 4 plus 4.
Terms & Conditions
Membership by application and recommendation only
Membership fee is €200,00 p.a.
Further information
Please visit www.maxxfaxx-knowhow.com and www.hbec.info
to get detailed information