In-Service or Wet Lab Request
RequiredRequired Question(s)
1.

Which procedure would you like to evaluate?

TransplantREADY DSAEK 3.0 (preloaded)
TransplantREADY DMEK 2.0 (preloaded)
Nan-Cut DSAEK (40-70 microns)
DMEK
OptiGraft Sterile Ophthalmic Allografts
Other  
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  • 500 characters left.
2.

What kind of training would you like to schedule?

Wet Lab at my surgical facility or clinic (in-person)
Wet Lab at my surgical facility or clinic (remote)
Wet Lab at LEITR's Training Center in Tampa, FL
In-service at my practice
Other  
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  • 500 characters left.
Required 3.

Select the days and times that work best with your schedule.

Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
weekends
mornings
afternoons
evenings
Other  
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  • 500 characters left.
4.
Please enter your contact information below. 

By entering my personal information, I consent to receive email communications from the survey author's organization based on the information collected.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
State/Province
(US/Canada):
Country: