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champions-implants gmbh bornheimer landstr 8 d 55237 flonheim fax 06734 1053 tel 06734 914080 e-mai info@champions-implants.com www.champions-implants.com time to be a champion® confirmation champions-basic rules of 01.11.2010 hereby i confirm that i have received and read the championsbasic rules title first name name street zip code/city/country phone fax email vat number i have already inserted other implants and know the procedure i have used the following implant systems date signature stamp

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