aqua med portal for contract termination

(If you would like to switch to another contract, please contact us via e-mail: service@aqua-med.eu)

Click here to terminate the contract

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Desired date*

Reason for termination

Fields with an asterisk ( * ) are mandatory!

Notice of termination Summary

On , you submitted the following data to us:

First name:

Last name:


Date of birth:

Postcode:


E-mail address:

Contract type:


Desired date:

Reason for termination:


Termination of the contract is to be concluded by "". An automatic confirmation acknowledging receipt of the notice of termination has just been sent to your e-mail address . You can also save the information here.