*By submitting this information, you acknowledge and agree that the information provided will be securely transmitted and stored in accordance with our data protection and information security policies.Your data will be used solely for the purpose stated in this form and will not be shared with third parties without your explicit conset. Access to your data is restricted to authorized personnel only.
Job Title/RoleTransplant SurgeonICU HeadInfection Control OfficerHospital ProcurementClinical MicrobiologistNursing DirectorOther (specify)
Hospital Name (required)Hospital Location (City, Country)Transplant Program TypeRenalLiverLungHeartBone Marrow (BMT)Multi-organOther (specify)
Are you currently evaluating infection control solutions?
YesNoNot Sure
Intended Use:
ICU PilotWard PilotInfection Control TrialOther
Key Challenge You Aim to Solve:
“I consent to be contacted by Thermaissance regarding this pilot request.”