Submit a clinical trial request

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

Site nr. - Dr. Last name, First name

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

(https://motiva.health/privacy-policy/)

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