Medical Information Request

Medical Information Request
Which country are you located in?*
LivaNova, Inc. has a policy against engaging in any activity which could be misconstrued as promoting our products for indications or uses other than those covered by our product approval by the U.S. Food & Drug Administration. Nevertheless, LivaNova, Inc. recognizes it has a responsibility to provide licensed healthcare professionals, upon an unsolicited request, information on our product(s) that may fall outside the scope of our approved product labeling. In the space provided below, please provide your contact information and the topic of interest for which you are requesting information.

CURRENT INTENDED USE / INDICATIONS

The VNS Therapy System is indicated for use as an adjunctive therapy in reducing the frequency of seizures in patients 4 years of age or older with partial onset seizures that are refractory to antiepileptic medications.
LivaNova, Inc. has a policy against engaging in any activity which could be misconstrued as promoting our products for indications or uses other than those covered by our product approval by the local Healthcare Authority. Nevertheless,
LivaNova, Inc. recognizes it has a responsibility to provide licensed healthcare professionals, upon an unsolicited request, information on our product(s) that may fall outside the scope of our approved product labelling. In the space provided below, please provide your contact information and the topic of interest for which you are requesting information.

The information provided below are collected with the scope to respond to this specific request and LivaNova, Inc does not request personal information on patients to answer at this medical request. For more information about your privacy rights, please refer to our privacy notice.

INTENDED USE / INDICATIONS

Epilepsy ‐ The VNS Therapy System™ is indicated for use as an adjunctive therapy in reducing the frequency of seizures in patients whose epileptic disorder is dominated by partial seizures (with or without secondary generalization) or generalized seizures that are refractory to seizure medications.

Depression ‐ The VNS Therapy System™ is indicated for the treatment of chronic or recurrent depression in patients that are in a treatment-resistant or treatment intolerant major depressive episode.
Which of the following best describes you?*

Healthcare ProfessionalLivaNova employee/representative
Is this an on or off-label request?*

On-labelOff-label
NOTE: All off-label requests need to be submitted directly by a healthcare professional. Please indicate how you would like to proceed:
How would you like to submit an off-label Medical Information Request?*

Continue on this deviceEmail PDF template and/or 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
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Medical Information Request
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