Spinal Donation Request Forms

** It is important that you read the details under the application before you submit your application.**

Charitable Monetary

Requests must be submitted at least 45 days prior to the event date. If the request is submitted less than 45 days it may be declined. Only submit charitable requests related to disease states treated by Medtronic Spinal therapies. The recipient must be a tax-exempt charity. It is important that detailed information about what the proceeds are for specifically are provided. If you do not provide detailed information it will result in delay of the request being reviewed. Required documents to upload in the application are: Detailed information regarding the proceeds, detailed budget, signed certificate of compliance, & W9. You can find a copy of the certificate of compliance here:

Additional Documents for Donation Requests.

Healthcare Education Grant with CME/CEU credits

Requests must be submitted at least 45 days prior to the event date. If the request is submitted less than 45 days prior to the event date it may be declined due to lack of time for review.This application is to support third-party scientific meetings and conferences. The event must issue CME/CEU credits. If there are levels of sponsorship available please provide the level information with details on what each level provides Medtronic Spinal. Every grant sponsorship request is reviewed by an unbiased committee for relevance to our disease states, depth and reach to specific audience, and on-label/off-label applications for each topic. Typical sponsors include professional societies, universities, hospitals and CME providers. Required documents to upload in the application are: Detailed agenda showing topics, detailed budget, signed certificate of compliance, & W9. If you do not provide detailed information regarding your meeting it will result in delay of the request being reviewed. Copies of the certificate of compliance can be found here:

Additional Documents for Donation Requests.

Healthcare Education Grant without CME/CEU credits

Requests must be submitted at least 45 days prior to the event date. If the request is submitted less than 45 days prior to the event date it may be declined due to lack of time for review.This application is to support third-party scientific meetings and conferences that do not offer CME/CEU credits. If there are levels of sponsorship available please provide the level information with details on what each level provides Medtronic Spinal. Every grant sponsorship request is reviewed by an unbiased committee for relevance to our disease states, depth and reach to specific audience, and on-label/off-label applications for each topic. Spinal does not support Journal Club meetings.

Typical sponsors include professional societies, universities, hospitals and CME providers. Required documents to upload in the application are: Detailed agenda with topics, detailed budget, signed certificate of compliance, & W9. You can find a copy of the certificate of compliance here:

Additional Documents for Donation Requests.

Attendance for Healthcare Professional in Training

Medtronic Spinal provides a limited number of Scholarships to major societies or instructional courses with robust agendas that are directly or indirectly related to spinal deformity, degeneration, or trauma or associated neurological disease states and conditions or the appropriate use of biologic products. They are given to bona fide training institutions or conference sponsors to cover expenses for healthcare professionals-in-training – such as medical students, residents, and fellows in training – to attend qualifying conferences. We are only providing scholarships to the meetings listed below.

The academic institution must apply on behalf of the healthcare professional in training. If a request is submitted directly by a healthcare professional-in-training, the request will be declined and the academic institution must reapply directly. Scholarships for HCPs in training are payable to the Third Party Qualifying Conference sponsor or the professional’s academic institution, not directly to the professional and with no Medtronic Spinal involvement in individual scholarship recipient selection.

If funding is approved to your institution and the funding applied to a FELLOW, the funding is in scope for reporting to the National Physician Payment Transparency Program: OPEN PAYMENTS (also known as Sunshine Act). The fellows name will be reported along with the academic institution as required by OPEN PAYMENTS law.

Required documents to upload in the application are: Detailed agenda, detailed budget, signed certificate of compliance, & W9. You can find a copy of the certificate of compliance here:

Additional Documents for Donation Requests.

Below are meetings Spinal has pre-selected that requests will be considered for. We will not provide scholarships to meetings outside of this list. Our scholarship awards are limited:

  • AANS/CNS: Joint Section - March 4-7, 2015
  • SRS - Scoliosis Research Society – September 10-13, 2014
  • SRS – Scoliosis Research Society World Wide Course – May 29-30, 2014
  • AANS - American Association of Neurological Surgeons Annual Meeting – May 2-9, 2015
  • CNS - Congress of Neurological Surgeons– October 18-23, 2014
  • Spinal Deformity Live starting – April 24, 2015
  • Orthopaedic Trauma Association Annual Meeting – October 15-18, 2014
  • IMAST - International Meeting on Advanced Spine Techniques – June 26-28, 2014
  • SMISS- Society for Minimally Invasive Spine Surgery – September 18-21, 2014
  • POSNA - Pediatric Orthopedic Society of North America – April 30 – May 3, 2014
  • CSRS - Cervical Spine Research Society – December 4-6, 2014
  • SIR - Society of Interventional Radiology – February 28 – March 5, 2015
  • ICEOS - International Congress on Early Onset Scoliosis – November 20-21, 2014
  • IPOS - International Pediatric Orthopaedic Symposium – December 3-6, 2014
  • ISASS – International Society for the Advancement in Spinal Surgery – April 15-17, 2015

Exhibit Fee Only Requests

This selection is for requests where Medtronic is asked only to exhibit at a conference or other meeting venue. Please provide all levels of exhibit options available. If you have multiple levels of exhibit opportunities please upload that information. Required documents to upload in the application are: Detailed agenda, detailed budget, signed certificate of compliance, & W9. You can find a copy of the certificate of compliance here:

Additional Documents for Donation Requests.

Spinal Patient Assistance Request

Application for product donation requests in the United States.Applications must be submitted at least six weeks prior to the surgery date. Product donations may be provided for the sole benefit of indigent patients when customers agree to provide their services and facilities at no charge to the patients. We limit the amount of donations per organization per fiscal year. Please provide details of the procedure you will be performing on the indigent patient application along with requested product. You will be required to fill out and sign three certifications: Certification of Compliance, Surgeon Certification of Free Health Care, & Hospital Representative Certification of Free Health Care. You can find the certifications here:

Additional Documents for Donation Requests.

Spinal Charitable Mission Product Request

Application for Spinal product requests for mission trips outside the United States. Requests MUST be submitted at least four months prior to the mission trip date (regulated countries may require up to six months prior). Requests must be submitted by a nonprofit organization with IRS-designated 501c3 status.There is a robust approval process and we must ensure that all products have regulatory clearance in the specific country the mission trip is taking place. Product donations may be provided for the sole benefit of indigent patients when customers agree to provide their services and facilities at no charge to the patients. You are required to fill out and sign two certifications: Certification of Compliance, Medtronic Certificate of Free Health Care. You can find the certifications here:

Additional Documents for Donation Requests.

Research Requests Process

Medtronic Spinal’s External Research Program is a companywide process for receiving and evaluating applications for research support for investigator-sponsored studies. The nature of this support can potentially take the form of providing product (should one or more of our products be the subject of a prospective study) and/or funding for independent third parties to assist in database development, statistical analysis, manuscript preparation, or other activities. Studies that are the best fit for our program are those that test hypotheses that respond to unmet clinical evidence needs, have strong study designs and statistical plans, and address questions of high importance to clinicians, to their patients, and to Medtronic. For more information on Medtronic Spinal’s External Research Program please contact us at: 1.800.876.3133 ext 6072 or email:rs.erpspinal@medtronic.com.

Spinal Product Donations For Non-Patient Use

This selection is for product donations to organizations for non-patient use. Please provide detailed information about the request and what the product will be used for. You are required to provide a signed certificate of compliance that you can find here:

Additional Documents for Donation Requests.

Internal Charitable Fundraiser Ticket/Table Request

(For internal use only)
This selection is for Medtronic employees or distributor sales representatives to request approval to purchase individual tickets at a charitable fundraiser. Please be sure to have the tax ID number for the organization as this is needed to fill out the application. The recipient must be a tax-exempt charity. Please contact Medtronic Spinal Compliance with questions.

Internal Exhibit Fee Only Request

(For internal use only)
This selection is for Meetings & Conventions to enter exhibit requests into the system.