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09.80.80.92.91

+33 (0)9.80.80.92.91
[email protected]
USA: 908,489,9499

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+33 (0)9 80 80 92 91
USA: 908,489,9499
[email protected]

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Please complete the form so that we can study your request for a demonstration.

Name*
First name Last name
Type of Facility
Type of Structure*
E-mail*
Telephone*
Postal code*
Country*
What is your function?*
- Physical Therapist
- Doctor
- ENT
- Occupational Therapist
- PCP
- Health Executive
- Osteopath
- Chiropractor
- Orthoptist
- Student
- Others
Do you have one or more specialities?*
- Neuro
- Orthopedics and Sports Medicine
- Vestibular and Balance
- Posturology
- Shoulder
- Knee
- Spinal cord injury
- Geriatrics
- Osteo
- Others
Which software or hardware package caught your eye?*
- Balance & Vestibular Rehabilitation
- Functional Rehabilitation
- Static Force plates (StaticVR)
- Computerized Dynamic Posturography & Rehabilitation Motion Simulator (MotionVR)
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Equipment project*
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Please complete the form and one of our team members will get back to you momentarily. Typical response times are within 24hrs.

Name*
First name Last name
Name of Organization
Type of Facility*
Work E-mail*
Phone*
Zip Code*
Country*
I am a(n):*
- Physical Therapist
- Occupational Therapist
- Functional Neurologist
- Audiologist
- ENT
- Physician
- Health Administrator
- Researcher
- Student
- Other role
Do you have one or more speciality(ies)?*
- Vestibular/ Balance
- Orthopedics/ Sports Medicine
- Neurology/ NPhysical eurologic Rehabilitation
- Chiropractor
- ENT/Audiology
- Pediatrics
- Geriatrics
- Other
Which solution are you interested in learning more about?*
- BalanceVR (Vestibular/ Concussion/ Balance Disorders)
- PhysioVR (Functional/ Sports/ Orthopedics/ NeuroRehab)
- StaticVR (Static Force Plates)
- MotionVR (Computerized Dynamic Posturography & Rehabilitation Motion Simulator)
- All of the Above
- Don't Know
Projected Timeline for Equipment Purchase*
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- Physical Therapist
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- PCP
- Health Executive
- Osteopath
- Orthoptist
- Chiropractor
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- Others

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I am a(n):*
- Physical Therapist
- Occupational Therapist
- Functional Neurologist
- Audiologist
- ENT
- Physician
- Health Administrator
- Researcher
- Student
- Other role
Mandatory Fields*
- Accept the Privacy Policy.
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