Medical Device Project Form

Contact Information

Requesting Party*

Title

Email*

Project Description

Project Description*

Intended end user*

Desired product based on actual human data/raw images?*
---YesNo

Any images to be provided (raw data, existing iterations, etc.)?*
---YesNo

Model Information

Multi-use or single-use*
---Multi-useSingle-use

Do you require/prefer a flexible/rigid model? Please be aware that flexible models require more time to print, are more vulnerable in transport, and cost more money. But for certain applications/lesions, they are the best option.*
---Prefer FlexibleRequire FlexiblePrefer RigidRequire Rigid

When is this patient scheduled for surgery?*

Order Information

Desired Quantity*

Would you like a blood-volume model (depicting internal structures using contrast in blood) or shell model (external walls)?*
---Blood-Volume ModelShell Model

Desired and required turnaround times for final product*