[B2B] Fitness Push

Request a trial of a Ottobock Fitness Prosthetic

If you are a prosthetist interested in trialing a fitness prosthetic, please fill out the form below. Your local Ottobock representative will reach out to you directly.

Contact Information

First Name*

Last Name*

Email*

Phone*

Clinic Information

Clinic Name*

Address*

City*

Zip Code*

Country*

State*

Province*

Plese select the product you're interested in trying*

I would like to get more information about events, products, and services from Ottobock and confirm that the above information is correct.

By filling out this survey you hereby agree to allow Ottobock to save and use the personal data and medical data, if applicable, that you have provided in the survey form for the purpose of processing/responding to my inquiry. View Ottobock Data Privacy here.*

I have read and understand the Terms and Conditions.*