お使いの製品について

在宅人工呼吸器

お問い合わせ

お手伝いしましょうか？

連絡先

* この項目は必須です。

国・地域

お名前(名)*

お名前(カナ・メイ)

お名前(姓)*

お名前(カナ・セイ)

敬称

学術称号

メールアドレス*

電話番号

勤務先*

役職

業界

職務

専門分野

部門

県名

都道府県

住所

郵便番号

連絡内容の詳細をお知らせいただくことにより、より適確な情報をお知らせいたします。

We work with partners and distributors who may contact you about this Philips product on our behalf.

お問合せ内容

連絡方法

ご都合の良い連絡時間

購入予定時期

興味のある製品

I hereby consent to processing of my personal data and sensitive personal data (if any) and transfer of such data abroad, in accordance with the Privacy Notice that can be found here.

What is cross border data transfer?

I agree on cross-border transfer of personal information.

I hereby agree to receive by email or telephone information about Philips products, services, events and promotions, including information by mail that is appropriate to me, taking into account my activities and preferences, including the Expectations I have indicated / and in this form.

I agree that Philips may share my personal information with authorized resellers of its Philips products and equipment in order to meet my expectations as stated in this form.