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Medtronic Therapy

Which Medtronic therapies are managed or implanted by your clinic?* (Check all that apply.)



Practice Details

This information will be used to generate the contract and create the Digital Health clinic name. Match the practice name and address to customer sold to address in SAP.

For Efficio™ and/or Snapshot™, please indicate how this location interacts with devices?



PRACTICE ACCOUNT MANAGER (PAM)

The practice account manager will be the primary person to enroll additional users from the practice in the cloud software.

Note: Digital health enrollment details will be shared via email.

LEGAL CONTRACT SIGNEE

To gain access to the cloud software, the practice must sign a business associate agreement, terms of use, and therapy addendum(s). Please identify the legal contact who should sign the agreements for this practice.

MEDTRONIC REPRESENTATIVE

IT SUPPORT

Your information will be used and protected in accordance with our privacy statement.

If you need immediate IT or Wi-Fi assistance, call Digital Connectivity at 1-800-707-0933.