If you would like to start using the PENS therapy Daily Pain Diary, please complete the form below to request your UNIQUE PATIENT ID number

Your Unique Patient ID will be emailed to you within 24 hours of receiving your request
Once you have received your Unique Patient ID, proceed to registering your patient profile​

By using this Pain Diary, you undertsand that this does NOT form part of any medical treatment you may be undergoing or considering and is used at your own discretion. 

As a medical device manufacturer, Algotec Research and Development takes patient confidentiality very seriously, so it is important that you ​​​ONLY REGISTER FOR AND USE THE ALGOTEC PAIN DIARY IF: [1] you consent to the information you provide below being shared with your Pain Doctor, and [2] you consent to the information you provide below being used by Algotec in evaluating the safety and performance of the product, and to aid future research and development.


To receive your UNIQUE PATIENT ID, please provide your name and surname
I consent to my information being shared with my Pain Doctor. Indicate YES or NO
I consent to Algotec using my information for research purposes. Indicate YES or NO
What is the email address to which you would like your ID number sent?
​​​​​​​​​The Algotec R&D PENS therapy Pain Diary is available through our website or through the Algotec PENS App whch you can download from Google Play and the iStore​

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