Application for Changes To EPHMRA / INTELLUS - Anatomical Classification System

Question Title

1. Your Details: (Required.)

Full Name

Company

Address

Country

Tel Number

Date of Request

Question Title

2. Are you, the requestor, located at the company’s worldwide corporate headquarters?

Yes

Question Title

3. If answer is ‘no’ (i.e. not at HQ), then please provide contact information of corporate headquarters person who has approved this request eg name, email address, job title.

Question Title

4. Please provide a brief overview of the reasons for the change request:

Question Title

5. Please provide your proposed new class structure and include class names, class descriptions, products and/or types of products to be included in new and affected classes:

Application for Changes To EPHMRA / INTELLUS - Anatomical Classification System

Question Title

1. Your Details: (Required.)

Question Title

2. Are you, the requestor, located at the company’s worldwide corporate headquarters?

Question Title

3. If answer is ‘no’ (i.e. not at HQ), then please provide contact information of corporate headquarters person who has approved this request eg name, email address, job title.

Question Title

4. Please provide a brief overview of the reasons for the change request:

Question Title

5. Please provide your proposed new class structure and include class names, class descriptions, products and/or types of products to be included in new and affected classes:

Question Title

6. Please list current classes that may be affected by proposed change:

Question Title

7. Please reference or email any background information - email to generalmanager@ephmra.org

Question Title

8. Many thanks – we will get back to you in due course.

Question Title

* 1. Your Details: (Required.)

Question Title

* 2. Are you, the requestor, located at the company’s worldwide corporate headquarters?

Question Title

* 3. If answer is ‘no’ (i.e. not at HQ), then please provide contact information of corporate headquarters person who has approved this request eg name, email address, job title.

Question Title

* 4. Please provide a brief overview of the reasons for the change request:

Question Title

* 5. Please provide your proposed new class structure and include class names, class descriptions, products and/or types of products to be included in new and affected classes:

Question Title

* 6. Please list current classes that may be affected by proposed change:

Question Title

* 7. Please reference or email any background information - email to generalmanager@ephmra.org

Question Title

* 8. Many thanks – we will get back to you in due course.

1. Your Details: (Required.)

2. Are you, the requestor, located at the company’s worldwide corporate headquarters?

3. If answer is ‘no’ (i.e. not at HQ), then please provide contact information of corporate headquarters person who has approved this request eg name, email address, job title.

4. Please provide a brief overview of the reasons for the change request:

5. Please provide your proposed new class structure and include class names, class descriptions, products and/or types of products to be included in new and affected classes:

6. Please list current classes that may be affected by proposed change:

7. Please reference or email any background information - email to generalmanager@ephmra.org

8. Many thanks – we will get back to you in due course.