RAPID Biomedical - Custom Request

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Custom Request Form

email address: Leave this field email-address blank:
Homepage: Leave this field homepage blank:
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Comment: Leave this field comment blank:

Contact Information

name*:

institution*:

address 1:

address 2:

address 3:

city*:

zip code*:

country*:

e-mail*:

phone:

MR System Information

manufacturer*:

model:

field strength*:

interface:

gradient size:

channels:

vertical system*:

yesno

Application Information

species*:

humananimalother

please specify:

organ:

RoI:

FoV:

proton:

yesno

x-nucleus:

Coil Request 1

rf function:

transmit / receivetransmit, act. dec.receive, act. dec.

coil type:

volumesurface

design:

single channelphased array

inner diameter:

Coil Request 2

rf function:

transmit / receivetransmit, act. dec.receive, act. dec.

coil type:

volumesurface

design:

single channelphased array

inner diameter:

Peripheral Request

please choose:

Your Message

optional:

Verification:

11 subtract 9

Fill in the result

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

info@rapidbiomed.de

Custom Request.

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

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