Customer data form

Dear customer,

Thank you for your interest in our products and our company.
In order to process your enquiry or order, we need to collect some personal data.

This page is for the registration of commercial customers only. If you are a patient, please use our general Contact Form or the Supplier Search for Patients.

Please fill in all required fields (marked with *) in the customer data form.
As soon as you submitted the completed form, your enquiry/order will be processed as soon as possible.

With best regards from Lüneburg,
Your FIOR & GENTZ team

Company’s Contact Details
Contact Person’s Contact Details

I agree that my personal data are exclusively recorded, processed and used strictly for purpose by the FIOR & GENTZ Gesellschaft für Entwicklung und Vertrieb von orthopädietechnischen Systemen mbH (referred to as FIOR & GENTZ GmbH in the following) with regard to the German data protection act. I can correct or delete all stored data at FIOR & GENTZ at any time without giving any reasons. I reserve the right to revoke the consent given to FIOR & GENTZ GmbH to collect and process my data without giving any reason at any time. I likewise forbid to transfer my personal data to third parties, provided that this is not necessary for rendering the service of or the contract performance through the FIOR & GENTZ GmbH. Legal basis for the processing is Art 6 s 1 (b) GDPR. Purpose of the processing is the contract initiation or fulfilment. The saved data are deleted, provided that the processing purpose becomes obsolete and no further legal or contractual retention obligations exist. Here, the legal retention period is 6 years.

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