Additional Documents for Medtronic Donation Requests

This page contains printable copies of Medtronic templates and certification statements. Please note: Any request submitted to Medtronic's Spinal business requires a signed copy of the certification(s) contained in the online form. Those signed copies can be scanned and uploaded to your request as an attachment.

Budget Form

Template containing budget information for a request.
Note:  A budget template from your organization can be used instead of this template.

General Certification of Compliance

PDF version of the Certificate of Compliance. 
Note: All requests to Medtronic’s Spinal business must include a signed copy of this certificate.

Fundraising Certification

PDF version of the Fundraising Certification found in the Charitable Monetary Request Form.
Note: All charitable monetary requests to Medtronic’s Spinal business must include a signed copy of this certificate.

Fellowship Certification

PDF version of the Fellowship Certification found in the Fellowship Grant form.
Note: All fellowship requests to Medtronic’s Spinal business must include a signed copy of this certificate.

Patient Assistance Certifications

PDF version of the certifications found in the Spinal Patient Assistance Request form.
Note: All patient assistance requests to Medtronic’s Spinal business must include a signed copy of these certificates.

Spinal Product Donation Certifications

PDF version of the certifications found in the Spinal Product Donation Request form.
Note: All patient assistance requests to Medtronic’s Spinal business must include a signed copy of these certificates.

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