Formulaire de demande d’étude clinique

Brainlab Clinical Studies

Thank you for your interest in working with Brainlab to support medical research.
In this application we'll ask you about your study goals and interests and your experience with Brainlab products. It should take about 3-10 minutes to complete.

Step 1 of 5

What kind of study are you interested in? *
I am interested in a clinical cooperation for a specific Brainlab product or workflow.I have a specific clinical project planned and am interested in support from Brainlab.

Please provide additional information to help us understand your study interests.

Step 3 of 5

What is your clincial expertise? *

Please describe your study goals. *

Which indication is being addressed? *

Upload clinical project idea *

Please let us know more about your research department.

Step 4 of 5

Does your site have a designated research department? *
OuiNo

What experience do you have with Brainlab products? *

Almost there!

Step 5 of 5

First Name *

Last Name *

Email Address *

Phone number - optional

City *

Country *

Établissement

Job title

Summary

Please check the information before submitting your application.

Question	Answer
Products/Workflows being studied
Clinical questions/Study goals
Indication
Dedicated Reseach Development
Relevant Research Experience

J’accepte par la présente que Brainlab AG m’envoie par e-mail des informations promotionnelles. Ce consentement peut à tout moment être révoqué avec effet pour le futur en écrivant à [email protected] La révocation du consentement ne remet pas en cause la légalité du traitement effectué entre le consentement et ladite révocation. Vous trouverez davantage d’informations dans notre Politique de confidentialité.

J’accepte les mentions légales*

Thank you!

We will contact you as soon as possible.

Tél.:	+49 89 99 15 68 0
Fax:	+49 89 99 15 68 5033