Feedback – Allegro

At Allegro, we prioritize your safety and well-being. We understand that open and transparent communication is essential for the continuous improvement of our medical devices. If you’ve experienced any issues or concerns related to the use of our products, we encourage you to report them here. Your feedback is invaluable in helping us enhance the quality and safety of our medical devices, ensuring that they continue to meet the highest standards of patient care. Thank you for being a part of our commitment to innovation, quality, and patient well-being.

Reporter Type*

Function*

Last Name*

First Name*

Street*

House number*

You agree to receive email communication from us by submitting this form and understand that your contact information will be stored with us.

City*

Zip Code*

State/Province/Regio*

Country*

Phone Number (incl. country code)*

Email Address*

Date of Birth*DD/MM/YYYY

Product Lot Numbers*

Customer Last Name (if different than reporter)*

Customer First Name (if different than reporter)*

Customer Street (if different than reporter)*

Customer House Number (if different than reporter)

Customer City (if different than reporter)*

Customer Zip Code (if different than reporter)*

Customer State/Province/Regio (if different than reporter)*

Customer Country (if different than reporter)*

Customer Phone Number, incl. country code ( (if different than reporter)*

Customer Email Address (if different than reporter)*

Customer Date of Birth (if different than reporter)*

Relevant accessories or devices used with the device being reported*

Date of the incident*

Provide a comprehensive description of the incident(s) – adverse event(s) – side effect(s), including what went wrong with the device and a description of the health effects i.e. clinical signs, conditions (if applicable)*

Consequence for the patient*

Date of device implantation*

Availability of the product – will the product be returned to Allegro for investigation?*Please send back to Allegro, Boulevard Patience et Beaujonc 3/21, B-4000 Liège, Belgium

Additional informationThe information collected on this form is recorded in a computerized database by the Quality department of Allegro n.v., address xxx for xx years. This data will only be used for the purpose of processing the complaint and only those involved in the processing of the complaint will have access to it. This data is protected against unlawful access, disclosure, or modification. You can address any questions relating to the processing of personal data to the following address: info@allegro.bio