The modification form is use to send us any change and/or modification about your medical information. You just have to apply changes into appropriated fields. Where you don't need to make a change, leave the field empty because we already received and created your file with the right information. You must select an action for each field to be able to submit the modification form. There is the description for each action available:

  • NO CHANGE: Select this action for that field if there is nothing to modify. If you write something in that field and selected this action, the modification will not be save!
  • MODIFY: Select this action to modify the existing information in the field.
  • ADD: This action is use to add information in addition to the existing information.
  • DELETE: Selecting this action will permanently delete all the information registered in that field.

2BEID identification keychain (Modification)

The information in this section will not be posted on your 2BEID identification page.
They will remain confidential! These fields are required (*).
E-mail(*)
Invalid email address.
 ( Your E-mail adress will not be inscribed on your identification page. )
Keychain code(*)
Invalid code
( If you have more than one keychain and would like to register them all in one step with the same information,
this is how you need to register them; xxxx, xxxx, xxxx ).
Personal PIN(*)
number only
 ( Register your 5 digit personal code. This code is necessary to validate your information’s modifications.
Please keep your PIN Confidential! )
The information below will be displayed on your 2BEID identification page and linked to your keychain.
Name
Invalid Input
 ( Name and Surname )
Message to be displayed
Invalid Input Donnée invalide
Phone number of first contact
Invalid Input Donnée invalide
 ( Format: 000-000-0000 )
Phone number the second contact
Invalid Input Donnée invalide
 ( Format: 000-000-0000 )
Phone number third contact
Invalid Input Donnée invalide
 ( Format: 000-000-0000 )
Have you double-checked your information before submitting the form?(*)
Please check YES
   *( You must check YES before submitting the form )

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