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Contact

Head Office – Gauteng

Southern Implants Office park 1 Albert Road, Irene, 0062

Map to Southern ENT

P.O. Box 17198, Lyttelton, 0140
Tel: 0027 12 667 4460
Fax: 0027 12 667 2362

Southern ENT Enquiry Form

If you would like us to contact you regarding our Cochlear products and services, please fill in the form below.

Your name*
FirstLast
The patient's name
FirstLast
Your relationship to the patient (if applicable)
- Parent
- Spouse, partner of significant other
- Family member (sibling, cousin, aunt/uncle etc)
- Friend
- Other
The name of the patient's audiologist or local clinic (if applicable)
Are you interested in... (select all relevant options)*
- Cochlear^TM Nucleus^®
- Cochlear^TM Baha^® (Bone anchored solution)
- Upgrade/repair or trade-in to existing implant
- Warranty information
- Other
What would you like to find out from us?*
The telephone number we can reach you on*
When is a good time to contact you?
: HH
MM
The email address we can use to send you a copy of this enquiry to*
Do you want to receive our quarterly newsletter "Southern Sounds"?*
- Yes please, I would like to receive your quarterly newsletter "Southern Sounds"
- No thank you. I just want to find out about your products and services

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