Mollii Suit Anmeldung

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I would like to test the Mollii Suit in Traunstein.

Please note that there is a fee of 249,90€ for the approx. 2-3 hour test appointment.

Last name

First name

E-mail

Phone number (please specify country code e.g. 0049)

Street and house number

Postal code

City

Birth date

Size (cm)

Weight (kg)

Clothing size

Diagnosis

Other

Does the following apply to you?

Epilepsy

Cardiovascular problems

Skin diseases

Infectious diseases

Cancer

Edema/swelling

Inflammations

Allergies (material)

You have electronic implants in your body that react to magnets (e.g. baclofen pump, pacemaker, shunt, etc.).

Are you already provided with aids?

Foot lifter-rail

Orthosis for the legs

Orthosis for the hands

Walking aids (rollator, walking stick, crutches)

Wheelchair

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