Medical Information Request

Medical Information Request
LivaNova PLC and its affiliates (collectively “LivaNova”) has a policy against engaging in any activity which could be interpreted as promoting our products for indications or uses not approved by local healthcare authorities. However, LivaNova also recognizes its responsibility to provide licensed healthcare professionals, upon their unsolicited request, with information about our product(s) that may fall outside approved labelling.

The information you provide will be used solely to address your specific request. Please do not include any patient personal data. For details about your privacy rights, please consult the privacy notice available on the LivaNova website.
Which country are you located in?*
Healthcare ProfessionalLivaNova employee/representative
NOTE: All Medical Information Requests must be signed by a healthcare professional.
Continue on this deviceEmail hyperlink to online form
Your request will be sent to MedicalAffairsInternational@livanova.com
Your request will be sent to NA-US-NM-MSL-Team@livanova.com
Please pass your device to the healthcare professional so they can populate and submit their request.

Medical Information Request
(Optional) NPI Prefill
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Name*
Professional Credentials / Title*
Email*
Telephone Number
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Telephone Number
Hospital / Organization
Address

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Address

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Please describe your specific scientific or clinical question:*
By signing below, I acknowledge the following:
- I am requesting information on my own initiative.
- I understand the information provided may relate to off-label use of a medical device and is intended for scientific and educational purposes only.label use of a medical device and is intended for scientific and educational purposes only.
- I understand the manufacturer cannot promote off-label use and will provide only balanced, scientific, nonpromotional information.label use and will provide only balanced, scientific, nonpromotional information.
- I consent to receiving scientific literature or technical documents relevant to my request.
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