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Clinical Trials Support Portal

Equipment Order Form

 

Please complete the form below to request additional equipment for your study. Please be aware that all requests require sponsor approval and may take up to 5 business days for processing and delivery. To request service or to return a device, click here.

Choose your product family

Actiwatch Spectrum Pro

GENEActiv

Actiwatch 2

Equipment Order Form

 

Please complete the form below to request additional equipment for your study. Please be aware that all requests require sponsor approval and may take up to 5 business days for processing and delivery.

* This field is mandatory

Equipment

Study details

*
*
*
*
*
*

Information submitted on this form will be processed by Philips Respironics in the United States. Please read our Privacy Notice.

Equipment Order Form

 

Please complete the form below to request additional equipment for your study. Please be aware that all requests require sponsor approval and may take up to 5 business days for processing and delivery.

* This field is mandatory

Equipment

Study details

*
*
*
*
*
*

Information submitted on this form will be processed by Philips Respironics in the United States. Please read our Privacy Notice.

Equipment Order Form

 

Please complete the form below to request additional equipment for your study. Please be aware that all requests require sponsor approval and may take up to 5 business days for processing and delivery.

* This field is mandatory

Equipment

Study details

*
*
*
*
*
*

Information submitted on this form will be processed by Philips Respironics in the United States. Please read our Privacy Notice.

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