Become a client

Want to become a client? Great!

You’re eager to get started – so are we! Before we can do so, though, we need a few more details, which you can provide in the form below. The process of signing up for our services and future communication will then run smoothly and efficiently.

Do you want to become a Mensura client? You’ll also need to cancel your affiliation with your current external service. Don’t worry though – it’s not going to be a bureaucratic marathon. We’ll take care of the entire process.

Note: If you cancel your current contract any time up to 30 June, your affiliation with Mensura will start on 1 January of the following calendar year. If you cancel on 1 July or later, you are legally required to complete the next calendar year with your current external service.

Fields marked with a * must be completed.

Becoming a client at Certimed? We ensure a smooth start. Do you want to request a medical check-up immediately? Please fill in this form. No check-up needed yet? Complete the form below to become a client. You do not need to enter your region if you are only registering as a Certimed client.

Your affiliation

I want to become a client of: *
    Are you currently affiliated with an external occupational health and safety service?
     

    If you choose to join Mensura, your affiliation with your current external service must be terminated. Mensura will handle this entire process.

    Your personal details

    First name *
    Surname *
    Email address *
    Telephone number *
    Position *
     

    Your company details

    Organisation *
    Street *
    House number *
    Postal code *
    Location *
    Sector
     
    Region (only fill in if you become a Mensura customer)
      Headquarter
      CBE number *
      Number of employees *