Medtronic
 
 

Tachyarrhythmia
Management

Request for Information

Intrinsic™ DR ICD with MVP™ Mode

To receive a copy of our physician information packet, please fill out the required ordering information below and check which items you are interested in receiving.

Intrinsic DR ICD Brochure
Dual Chamber ICD Specification
MVP Mode Operation Tip Card
MVP In-service for clinic staff or telemetry nurses

*=Required Fields

First Name *
M.I.

 Last/Family Name *
Title/Degree *
MD RN PA Other

Hospital/Clinic *

Street Address *

City *

State/Province *

Country *

Zip/Post Code *

E-Mail Address (Optional)

Primary Specialty:*

  

Cardiologist

Electrophysiologist

Interventional Cardiologist

Primary Care Physician

Cardiothoracic Surgeon

Fellow

Internist

Heart Failure Specialist

Resident

Other Medical Specialty


Device Involvement: (select all that apply)*

Pacemaker implant

Refer for implant

Defibrillator implant

Device follow-up

Not involved

Other

Register to receive new information as it becomes available in the future. (Optional)
How do you prefer to receive the information:

By mail

By e-mail

Additional Information

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