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 clinical 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? * YesNo

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 *

Institution

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

Information on the processing of your personal data can be found in the Brainlab privacy policy.

I hereby agree to receiving promotional emails (e.g., product information, new releases, upcoming events and webinars) from Brainlab AG and its subsidiaries and agree to its analysis for the purpose of tailoring future newsletters according to my interests. This consent may be revoked with effect for the future. Detailed information is available in the Brainlab privacy policy

Thank you!

We will contact you as soon as possible.

Toll free:	+1 800 784 7700
Tél.:	+1 708 409 1343
Fax:	+1 708 409 1619

Toll free:	+1 800 597 5911
Tél.:	+708 486 1955