Your Contact Information
General Information
Company Name Contact Name Position Address 1 Address 2 City Country Postal Code Phone Number Fax Number Email Repeat Email
Company Information
Geographic areas covered, number of field sales people selling urological products.
List of Urological products and specific manufacturers that you are currently representing
The Uromedica products are CE marked, but not yet FDA approved. All Uromedica products are manufactured in the United States. Uromedica maintains certification to ISO 13485:2003. Please provide a brief description of the regulatory process one would need to go through to get the ACT and ProACT products approved for sale in your country.
Is there any reimbursement available for this type of procedures or would the devices be implanted on a private pay basis?
Market Information
Annual number of radical prostatectomies done in your country Annual number of sling procedures done in female patients Number of bulking (injectable) procedures done annually Number of Artificial Urinary Sphincters implanted annually Number of male slings implanted annually
Number of Urologists
Number of (Uro)gynecologists
Please list the three most important physicians that your company works with.
#1 Physician’s Name #1 Hospital #1 City
#2 Physician’s Name #2 Hospital #2 City
#3 Physician’s Name #3 Hospital #3 City
Please list the most important trade shows your company attends annually
What is the required language for educational and marketing materials for your physicians and patients?
Physician language Patient language
