ORDER FORM DIZG ALLOGRAFTS

ORDER FORM DIZG ALLOGRAFTS

GDPR [no full name or full personal security number]
Clinic name
Address
Postal code
City
Country
Att.: Surgeons name
VAT number (DK- / SE- / NO-…)
Clinic name
Address
Postal code
City
  • Choose product from list
  • GT 2745, Cortical / Cancellous block, J shape, 4-5 x 10 x 10-15 mm
  • GT 2765, Cortical / Cancellous block, C shape, 10 mm x 15 x 20 mm
  • GT 2770, Cortical Spongiosa Granulates, 0,212-0,85 mm, (1,0 cc)
  • GT 2771, Cortical Spongiosa Granulates, 0,212-0,85 mm, (3,0 cc)
  • GT 2775, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (1,0 cc)
  • GT 2776, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (3,0 cc)
  • GT 2777, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (5,0 cc)
  • GT 3401, Cortical granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3407, Cortical granulates, 0,25 - 1,0 mm, (3,0cc)
  • GT 3414, Cortical granulates, 1,0 - 2,0 mm, (3,0cc)
  • GT 3415, Cortical granulates, 1,0 - 2,0 mm, (5,0cc)
  • GT 2706, Bicortical block, 10 mm x 20 x 40 mm
  • GT 2716, Tricortical block, 10 mm x 20 x 40 mm
  • GT 2601, Spongiosa block, 1 cm2, 10x10x10 mm
  • GT 2602, Spongiosa block, 2 cm2, 10x10x20 mm
  • GT 3545, Cortiflex Demin. Cortical Strut, 15 x 30 x 2 mm
  • GT 2820, Spongios granulates, 0,25 - 1,0 mm, (0,5cc)
  • GT 2821, Spongios granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3212, Facia Lata, 20 x 30 x 0,2 - 0,6 mm
  • GT 4051, Epiflex®, 10 x 20 x >0,8 mm
  • GT 4052, Epiflex®, 10 x 30 x >0,8 mm
  • GT 3545T, Cortiflex Demin. membrane, 15 x 30 x 0,5 mm
  • GT 3548T, Cortiflex Demin. membrane, 20 x 25 x 0,5 mm
  • GT 25101 Femur Plate 25x10x1 mm*NA
  • Quantity
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • Choose product from list
  • GT 2745, Cortical / Cancellous block, J shape, 4-5 x 10 x 10-15 mm
  • GT 2765, Cortical / Cancellous block, C shape, 10 mm x 15 x 20 mm
  • GT 2770, Cortical Spongiosa Granulates, 0,212-0,85 mm, (1,0 cc)
  • GT 2771, Cortical Spongiosa Granulates, 0,212-0,85 mm, (3,0 cc)
  • GT 2775, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (1,0 cc)
  • GT 2776, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (3,0 cc)
  • GT 2777, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (5,0 cc)
  • GT 3401, Cortical granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3407, Cortical granulates, 0,25 - 1,0 mm, (3,0cc)
  • GT 3414, Cortical granulates, 1,0 - 2,0 mm, (3,0cc)
  • GT 3415, Cortical granulates, 1,0 - 2,0 mm, (5,0cc)
  • GT 2706, Bicortical block, 10 mm x 20 x 40 mm
  • GT 2716, Tricortical block, 10 mm x 20 x 40 mm
  • GT 2601, Spongiosa block, 1 cm2, 10x10x10 mm
  • GT 2602, Spongiosa block, 2 cm2, 10x10x20 mm
  • GT 3545, Cortiflex Demin. Cortical Strut, 15 x 30 x 2 mm
  • GT 2820, Spongios granulates, 0,25 - 1,0 mm, (0,5cc)
  • GT 2821, Spongios granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3212, Facia Lata, 20 x 30 x 0,2 - 0,6 mm
  • GT 4051, Epiflex®, 10 x 20 x >0,8 mm
  • GT 4052, Epiflex®, 10 x 30 x >0,8 mm
  • GT 3545T, Cortiflex Demin. membrane, 15 x 30 x 0,5 mm
  • GT 3548T, Cortiflex Demin. membrane, 20 x 25 x 0,5 mm
  • GT 25101 Femur Plate 25x10x1 mm*NA
  • Quantity
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • Choose product from list
  • GT 2745, Cortical / Cancellous block, J shape, 4-5 x 10 x 10-15 mm
  • GT 2765, Cortical / Cancellous block, C shape, 10 mm x 15 x 20 mm
  • GT 2770, Cortical Spongiosa Granulates, 0,212-0,85 mm, (1,0 cc)
  • GT 2771, Cortical Spongiosa Granulates, 0,212-0,85 mm, (3,0 cc)
  • GT 2775, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (1,0 cc)
  • GT 2776, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (3,0 cc)
  • GT 2777, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (5,0 cc)
  • GT 3401, Cortical granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3407, Cortical granulates, 0,25 - 1,0 mm, (3,0cc)
  • GT 3414, Cortical granulates, 1,0 - 2,0 mm, (3,0cc)
  • GT 3415, Cortical granulates, 1,0 - 2,0 mm, (5,0cc)
  • GT 2706, Bicortical block, 10 mm x 20 x 40 mm
  • GT 2716, Tricortical block, 10 mm x 20 x 40 mm
  • GT 2601, Spongiosa block, 1 cm2, 10x10x10 mm
  • GT 2602, Spongiosa block, 2 cm2, 10x10x20 mm
  • GT 3545, Cortiflex Demin. Cortical Strut, 15 x 30 x 2 mm
  • GT 2820, Spongios granulates, 0,25 - 1,0 mm, (0,5cc)
  • GT 2821, Spongios granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3212, Facia Lata, 20 x 30 x 0,2 - 0,6 mm
  • GT 4051, Epiflex®, 10 x 20 x >0,8 mm
  • GT 4052, Epiflex®, 10 x 30 x >0,8 mm
  • GT 3545T, Cortiflex Demin. membrane, 15 x 30 x 0,5 mm
  • GT 3548T, Cortiflex Demin. membrane, 20 x 25 x 0,5 mm
  • GT 25101 Femur Plate 25x10x1 mm*NA
  • Quantity
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • Choose product from list
  • GT 2745, Cortical / Cancellous block, J shape, 4-5 x 10 x 10-15 mm
  • GT 2765, Cortical / Cancellous block, C shape, 10 mm x 15 x 20 mm
  • GT 2770, Cortical Spongiosa Granulates, 0,212-0,85 mm, (1,0 cc)
  • GT 2771, Cortical Spongiosa Granulates, 0,212-0,85 mm, (3,0 cc)
  • GT 2775, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (1,0 cc)
  • GT 2776, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (3,0 cc)
  • GT 2777, Cortical Spongiosa Granulates, 1,0 - 2,0 mm, (5,0 cc)
  • GT 3401, Cortical granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3407, Cortical granulates, 0,25 - 1,0 mm, (3,0cc)
  • GT 3414, Cortical granulates, 1,0 - 2,0 mm, (3,0cc)
  • GT 3415, Cortical granulates, 1,0 - 2,0 mm, (5,0cc)
  • GT 2706, Bicortical block, 10 mm x 20 x 40 mm
  • GT 2716, Tricortical block, 10 mm x 20 x 40 mm
  • GT 2601, Spongiosa block, 1 cm2, 10x10x10 mm
  • GT 2602, Spongiosa block, 2 cm2, 10x10x20 mm
  • GT 3545, Cortiflex Demin. Cortical Strut, 15 x 30 x 2 mm
  • GT 2820, Spongios granulates, 0,25 - 1,0 mm, (0,5cc)
  • GT 2821, Spongios granulates, 0,25 - 1,0 mm, (1,0cc)
  • GT 3212, Facia Lata, 20 x 30 x 0,2 - 0,6 mm
  • GT 4051, Epiflex®, 10 x 20 x >0,8 mm
  • GT 4052, Epiflex®, 10 x 30 x >0,8 mm
  • GT 3545T, Cortiflex Demin. membrane, 15 x 30 x 0,5 mm
  • GT 3548T, Cortiflex Demin. membrane, 20 x 25 x 0,5 mm
  • GT 25101 Femur Plate 25x10x1 mm*NA
  • Quantity
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • Quantity
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • Quantity
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10

Regulations:
Due to EU regulation allografts are only to be stored for 48 hours at the receipient clinic, if the clinic does not hold a valid tissue bank license Please take this into account when ordering. Choose delivery date just before the date of planned surgery.

Distribution by:
Puredent ApS, Universitetsparken 7, DK 4000 Roskilde phone +45 31311925 | email info@puredent.dk Questions about ordering procedures, products likewise, please contact us directly. Storage at room temperature.

Manufactured by:
DIZG Deutsches Institut für Zell- und Gewebeersatz. distribution@dizg.de phone +49.(0)30.65 76 30.54/67