GET GUIDED DOLORCLAST® THERAPY CERTIFIED

JOIN THE MOVEMENT! FILL IN THE FORM TO BE INSTANTLY CERTIFIED (ALL FIELDS ARE MANDATORY). AFTER VERIFICATION AND VALIDATION OF YOUR INFORMATION, YOU WILL RECEIVE AN EMAIL TO ACCESS YOUR BENEFITS WITHIN A FEW DAYS. 

*Mandatory fields 
First Name*
 
 
Last Name*
 
 


Your practice

Please fill the following fields with your paractice information, as you'd like to see it appear on the Guided DolorClast® Therapy practice finder.  
Practice name*
 
 
Adress*
 
 
City*
 
 
Postal code*
 
 
Country*
 
 
Phone number*
 
 
Email address*
 
 
Website
 
 


Your EMS device

 
Which EMS DolorClast device do you use in your practice (examples below)?*
 
 

 

Your practice must be equipped with an EMS device to be eligible for certification. To confirm your equipment, please provide us with the serial number of your device. The serial number is located on the nameplate on the back of all devices, except for the Swiss DolorClast® Smart and Smart20 where the nameplate is located on the bottom of the device. Here are some examples:


    

 
Serial number (SN): *
 
 
Make it easy for yourself! Take a picture (or download) of your device's nameplate.
 
 


Your EMS training

 
Have you participated in a training course from the Swiss DolorClast® Academy?*
 
Yes
No
 
If yes, when? *
 
 
And where? *
 
 

In order to become certified as a Guided DolorClast® Therapy practice, I agree to:

 
To have my practice listed in the Guided DolorClast® Therapy online directory so that patients can easily find me.*
 
 
Receive EMS DolorClast® newsletters*
 
 
A practice's certification is valid for 24 months. Renewal will be granted upon completion of an additional face-to-face or online training course offered by EMS before the expiration date. *
 
 
By submitting this form and providing information about yourself, you are accepting and consenting to our processing of your personal data in accordance with the practices described in our Privacy Policy. You may revoke this consent at any time.*