RAPID Biomedical - Custom Request

Custom Request Form

Information on desired MR study and probehead:

Desired product

Patient study

Organ

Animal study

Others

Please specify

Nuclei

Space needed for sample
(e.g. Inner diameter of coil)

Special requirements

Limits in price

Desired delivery date

I don't know

Information on MR instrument:

Manufacturer / Type of MR-instrument*

Magnetic field strength*

Number of receive channels					I don't know

Gradient bore size*

I don't know

Coil control unit available	Yes		No		I don't know

Contact information:

Name*

Organization*

Street

ZIP*

City*

State / Country

eMail*

Additional
comments

Destination: info@rapidbiomed.de

*required fields

Phone
+ 49 (0) 93 65 / 88 26 - 0

For US, Canada and South America
please contact our sister company
RAPID MR International.

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