ADSL-modem replacement

Good news! We are currently replacing our old ADSL modems. Thanks to the new type of modem your line will be faster and more stable. We will also visit you soon to install the new modem(s). You will notice the difference!

The replacement takes maximum 1 hour. Fill out the form and give our helpdesk the details of a contact person within your company. We will call him / her for an appointment.

All fields are mandatory except those where "optional" is mentioned.

Your data

Company name {{errorMessages.company.required}} {{errorMessages.company.pattern}} {{errorMessages.company.pattern}} {{errorMessages.company.pattern}} {{errorMessages.company}} {{errorMessages.company.pattern}}

Title {{errorMessages.title.required}} {{errorMessages.title.pattern}}

First name {{errorMessages.firstname.required}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname.pattern}} {{errorMessages.firstname}} {{errorMessages.firstname.pattern}}

Name {{errorMessages.name.required}} {{errorMessages.name.pattern}} {{errorMessages.name.pattern}} {{errorMessages.name.pattern}} {{errorMessages.name}} {{errorMessages.name.pattern}}

Professional e-mail address {{errorMessages.email.required}} {{errorMessages.email.pattern}} {{errorMessages.email.pattern}} {{errorMessages.email.pattern}} {{errorMessages.email}} {{errorMessages.email.pattern}}

Professional phone number {{errorMessages.phonenumber.required}} {{errorMessages.phonenumber.pattern}}

Mobile phone number {{errorMessages.mobile.required}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile.pattern}} {{errorMessages.mobile}} {{errorMessages.mobile.pattern}}

Landline number (optional) {{errorMessages.fix.required}} {{errorMessages.fix.pattern}} {{errorMessages.fix.pattern}} {{errorMessages.fix.pattern}} {{errorMessages.fix}} {{errorMessages.fix.pattern}}

Client number (optional) {{errorMessages.clientnumber.required}} {{errorMessages.clientnumber.pattern}} {{errorMessages.clientnumber.pattern}} {{errorMessages.clientnumber.pattern}} {{errorMessages.clientnumber}} {{errorMessages.clientnumber.pattern}}

Company address

Street (optional) {{errorMessages.street.required}} {{errorMessages.street.pattern}} {{errorMessages.street.pattern}} {{errorMessages.street.pattern}} {{errorMessages.street}} {{errorMessages.street.pattern}}

Number (optional) {{errorMessages.number.required}} {{errorMessages.number.pattern}} {{errorMessages.number.pattern}} {{errorMessages.number.pattern}} {{errorMessages.number}} {{errorMessages.number.pattern}}

Zip code (optional) {{errorMessages.zip.required}} {{errorMessages.zip.pattern}} {{errorMessages.zip.pattern}} {{errorMessages.zip.pattern}} {{errorMessages.zip}} {{errorMessages.zip.pattern}}

City (optional) {{errorMessages.city.required}} {{errorMessages.city.pattern}} {{errorMessages.city.pattern}} {{errorMessages.city.pattern}} {{errorMessages.city}} {{errorMessages.city.pattern}}

Several company sites? Please fill in the addresses:

(optional) {{errorMessages.remarks.required}} {{errorMessages.remarks.pattern}}

I would like to be kept informed about products, services, contests and promotions of Proximus. To this end, Proximus may store my personal data in its files and may contact me, including by phone and via electronic channels such as e-mail, SMS and social media. I’m aware that my data is processed in accordance with Proximus' privacy policy which informs me how to manage my privacy settings.

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