Request More Information About Medtronic DBS Therapy

By completing this form you are granting Medtronic permission to add your contact information to its database for deep brain stimulation and consent to receiving information and communications related to Medtronic products and therapies.

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Do you experience uncontrollable shaking in your hands or arms (tremor)? *
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Are your medications ineffective in controlling your tremor, or do you experience troubling side effects from the medications (sleepiness, dizziness or thinking problems)? *
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No
Do you experience significant difficulty with daily activities, such as eating, drinking, dressing, and writing? *
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Would you consider non-medication options to treat your tremor? *
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No
Do you currently have a Medtronic DBS system? *
Yes
No

You may revoke this permission at any time by emailing support@medtronicdbs.com or sending a request in writing to: Medtronic, Discover Medtronic DBS, 7000 Central Avenue NE, RCE 250, Minneapolis, MN 55432-3576.

Medtronic respects the confidentiality of personal information. We assure you we will not share your personal information, except as otherwise noted in our privacy policy.

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Last updated: 12 Aug 2011

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