Sign up for a membership

Application form

Please complete the form to apply for a membership, and we will get back to you as soon as possible. For any questions, please contact us.

    Which membership would you like to apply for?

    General company and contact information


    Company name*

    Company address*

    Company phone*

    Company e-mail*

    Company website*

    President, Managing director or equivalent

    President name*

    President phone*

    President e-mail*

    if different: Person responsible for Authorised Representative services

    Representative name

    Representative title

    Representative phone

    Representative e-mail

    Company structure and organisation

    Legal form*

    Number of employees*

    VAT and commercial reg no.*

    Subsidiary of / independent*

    Please tell us more about your activities as Authorised Representative.

    Number of persons involved in authorised representative activities

    Activities of authorised representative in the medical device field for at least 3 years?*

    Are you working for at least 10 medical devices manufacturers as their European authorised representative?*

    Are you a registered legal entity?*

    Do you have available at least one staff member with more than 4 years of regulatory experience in the field of medical devices?*

    Do you have available at least one permanent staff member with a degree in law, medicine, pharmacy, engineering or other relevant scientific discipline?*

    Is your authorised representative activity covered by liability insurance?*

    Have you notified your relevant Competent Authority about your authorised representative activities?*

    Further activities

    What further services do you provide?*

    If you provide other services, please specify them. Otherwise, type "No".*

    More information

    How did you learn about EAAR?*

    What are your motives for participating in EAAR?*

    What do you wish to achieve by participating in EAAR?*


    Would you like to add anything?


    By submitting this form, I certify that the above information is complete and accurate and that the financial situation of the company identified under question is sufficient to warrant uninterrupted authorised representative services to customers for the foreseeable future. I allow a neutral agent to verify any information represented above, without divulging Company confidential information to EEAR. I understand that if I provide false or misleading information, the membership of my Company in EAAR may be terminated immediately upon discovery of this fact. If accepted as a member I and my company agree to act in accordance with the EAAR Code of Conduct and comply with the Articles of Association of the EAAR.

    I have read and agree with the Code of Conduct

    Name, title, date and place*

    Thank you.

    We will get back to you as soon as possible.