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Project Brief Form
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What application or industry are you serving? (*)





Please choose an application or industry
Which Medical Device Class? (*)



Which class level?
Other
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Is this a new product or an improvement to an existing product? (*)

Tell us about your product
Describe your existing product.
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What is the function of your device and what is the problem you are trying to solve?
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What is the function of our component in your product? (*)




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Other (*)
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What are the dimensional and functional requirements for our component?
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What will come in contact with our component?
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Will the component be disposable or reusable? (*)

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Estimated annual usage: (*)
What is your usage?
Any additional comments/information:
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Is this request in regards to a retail or consumer packaging project or product (defined as a pre-filled, use-and-dispose package available directly to consumers)? (*)

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Upload a drawing/photo:
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How did you find us? (*)



How did you find us?
Other
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Name of Referral?
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Contact Information

First Name (*)
What is your first name?
Last Name (*)
What is your last name?
Title (*)
What is your title?
Company Name (*)
What is your company name?
Address
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City
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State or Province
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Zip or Postal Code
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Country
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Phone (*)
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Email (*)
What is your valid email address?
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