US Med Ed Request Form - OrthoPediatrics

US MedEd Request Form

U.S. MedEd Workshop Equipment Request Form

Use this request form to order sawbones, workshop sets, power sets, and accessories.

First Name(Required)

Last Name(Required)

Phone Number(Required)

Email(Required)

Distributor Name(Required)

Choose your territory and managing director(Required)

Event Details

Event Type(Required)

Anticipated Number of Healthcare Attendees(Required)

Date of Event(Required)

MM slash DD slash YYYY

Deliver by Date(Required)

MM slash DD slash YYYY

Ship to Address(Required)

Street Address

Address Line 2(Required)

Address Line 2

City(Required)

City

State / Province / Region(Required)

State / Province / Region

Postal / Zip Code(Required)

Postal / Zip Code

Country(Required)

Country

Sawbone Lab or Cadaver Lab(Required)

Display Items

To make your workshop experience stand out, request additional display materials (tablecloths, pop-up banners, acrylic models) through the Marketing Request Form on the request forms page.

ConMed Power Sets and Vices

We will only ship the same quantity of vices/clamps as the number of power sets requested

Vice & Clamp Quantity(Required)

Enter a value between 0 and 6

ConMed Power Sets (Includes drill, saw, wire drivers, and attachments)(Required)

Enter a value between 0 and 6

Workshop Sets

Note: These sets are for sawbones use only(Required)

Pega – Fassier Duval (FD)

Pega – FD Removal Kit

Pega – Slim Nail

Pega – Gap Nail

Pega – Dror Paley Osteotomy System (DPOS)

Pega – Pegs

Pega – Lollipop

Pega – SCFE

Pega – GIRO Set

Pega – GIRO 3D Models

T&DC – Supracondylar Elbow FX Kit

T&DC – 3.5 Locking Cannulated Blade

T&DC – 3.5 Locking Proximal Femur

T&DC – DFOS Implant & Instrument (includes LPF instruments)

T&DC – DFOS Wedge Instruments

T&DC – SCFE 6.5/7.3 Cannulated Screws

T&DC – Updated 4.0 Cannulated Screw System

T&DC – PediFrag (2.7mm & 3.5mm Compression & Tubular Plates. T-Plates)

T&DC – PediFlex

T&DC – PediFoot

T&DC – PediLoc Femur (Includes T15 Screws, 3.5 Contoured & Bowed Femur Plates)

T&DC – PediLoc Tibia (includes 3.5mm Plates: Anterolateral, Narrow & Wide Medial Plates, T15 Screws)

T&DC – PNP Femur

T&DC – PNP Tibia

T&DC – PediPlates

T&DC – Clubfoot Casting Models

T&DC – PAO Set

T&DC – 3P Hip (includes BEAM & LPF)

Ex-Fix – Orthex Set for Blounts Tibia (includes 1 full ring & 1 partial ring)

Ex-Fix – Orthex Set for Foot Deformity (includes foot plate, arch)

Ex-Fix – Drive Rail Set (includes drill bit & half pins)

Scoliosis – ApiFix Demo Model & Set

Scoliosis – Response Power Torque Demo

Scoliosis – BandLoc Demo Kit

Scoliosis – Firefly Demo

Scoliosis – 7D

Scoliosis – RESPONSE 5.5/6.0 Spine System

Scoliosis – RESPONSE 4.5/5.0 Spine System

Sports – MPFL

Spica Table (includes dummy)

Cerement Demo Kit – Bone Void Filler

I will be using my own set for Lab (please notify MedEd Dept.)

Reason for using your live clinical sets

If applicable, why are you using your live sets?

Do you need multiples of any requested set? If so, list below.

Sawbones Glossary

Please call sawbones at (206) 463-5551 to order your bones. Lead time is 6 weeks! OP will reimburse you for 50% of the cost of your sawbones.

Sawbones

Lag Screw Blocks (1626-1)

SCFE for 7.0mm cannulated screws (1161-26) (Mild Slip with Growth Plates)

Complete knee (full femur & tibia) for DFOS, PLEO and ACL (1148-1)

Femur with 155-degree valgus neck/shaft for LCB/LPF VDRO (1121-5-9)

95 degree varus femur (1121-5-16)

Pedi femur for PNP-Femur (1121-5-7)

Clear Rubber Distal Femur w/ Physis for PediPlate (1701-45-3)

Pedi femur with growth plates for PediPlates (1166)

Tibia for flex nail & rotational osteotomies (1117)

Forearm No Hand (1017-5)

Radius/Ulna/Hand for both bone forearm fxs (1022)

Normal anatomy spine (1323-3)

Supracondylar FX Soft Tissue (1510-11-2)

Distal Tibia Triplane FX (1133-49)

Full Tib/Fib, Foot & Ankle (Orthex) (1132-3)

Varus Tibia (Orthex) (1160)

Full Male Pelvis (1301)

Pediatric Pelvis (1333)

Knee with Displaced Patella (1148-3-2)

Lateral Condyle with Clear Periostium (1510-11-2)

Clear Humerus for PediFlex (1007)

Clear Radius for PediFlex (1005-5)

Clear Ulna for PediFlex (1004-5)

Clear Forearm bound together (1005-24)

Clear Femur for PediFlex (1121-52)

Clear Tibia for PediFlex (1112)

I understand the following policy below when submitting a MedEd Request(Required)

6-10+ days notice – Ideal notice that allows us ample time to check availability, reach out to other reps for help getting education sets moved, etc) 3-5 days notice – Minimum notice we require. Most likely we can still accommodate these requests, but no guarantees. 0-2 days notice – Due to other requests that were submitted in time, planning, and availability we are unable to fulfill short notice requests (same day or 1-2 days in advance of the event)

Medical Education items must be returned within 3 business days of the event. If your event date got rescheduled and/or if you need an extension please let us know.