Submit a clinical trial request

Please enter the details of your request. Our support staff will respond as soon as possible.

Treating surgeon's first name and last name(s). No prefixes (Dr, Mrs, etc)

Site nr. - Dr. Last name, First name

If your name is not in the list, please write it down manually below.

Last name, First name

If you submit your complaint through our digital complaint website, please enter the provided ticket number in the field below. If you use the PDF form, attach it at the end of this ticket. You can report on up to two implants per complaint form. If you need to return more than two implants, please submit the required number of digital complaint numbers or PDF forms to this ticket.

Please use the following link to complete the digital FOR-302. When completed, it will generate a ticket number, which you must put in the field above.


The Investigational Site certifies that they have updated the Device Accountability Logs with the requested information and will update the Device Accountability Logs once the units are received.

You need to attach at the end of the ticket at least one Investigational Device Return Form. The template can be downloaded by following the link below.

Add file or drop files here