Joining LeptoNet

To join the interactive part in LeptoNet you have to fill in this application form.

After this form is sent you will receive a username and a password that gives you access to leptonet.

After login the following functions are available:

  • Enter your annual leptospirosis data.
  • Change your address information.
  • Perform analyses on your own data.
  • Maintain your own data.
  • Change your password.

The obligated items are in Red.
Information regarding the organisation 
Institute: 
Department: 
Address: 
Phone: 
Fax: 
Email: 
Website URL: 
Information regarding the contactperson who is responsible for the data entry. 
Last name: 
Initials: 
Prefix: 
Title: 
Function: 
Phone: 
Fax: 
Email: