Implant Notification : CryoLife

Implant Notification

By using this simple online notification tool every time a HeRO Graft implant is scheduled, you initiate a series of important, beneficial events.

A HeRO Graft expert is alerted and may be scheduled to proctor the implant.
The patient’s dialysis provider may be notified to expect a HeRO Graft patient in their facility.
A partnership is initiated including referral programs, training opportunities, and media support.

Implant Date: *

Surgeon's Name (First, Last): *

Implanting Facility: *

City: *

State: *

Referring Nephrologist's Name (First, Last):

Patient's Dialysis Facility Name:

May we contact you to follow up on the procedure? * If yes, please provide your

email address:

Comments:

Please enter the characters of the image :

Required fields are marked with an *. If you are having issues with this form, please contact Customer Service at 888-427-9654.

INDICATIONS FOR USE: The HeRO Graft is indicated for end stage renal disease patients on hemodialysis who have exhausted all other access options. Rx Only. See instructions for use for full indication, contraindication and caution statements. Terms and Conditions. Privacy Policy. HeRO is a Hemosphere, Inc. product distributed by CryoLife, Inc. HeRO, Hemosphere, CryoLife, ‘Life Restoring Technologies’, and the snowflake symbol are trademarks owned by CryoLife, Inc. or its subsidiaries. All other trademarks are owned by their respective companies. © 2012 CryoLife, Inc. All Rights Reserved.