aqua med portal for contract termination

(If you would like to switch to another contract, please contact us via e-mail:

Click here to terminate the contract


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:


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.