Advanced Medical Technologies 3D Service Request Form

Requestor Information

About the Request

If yes, you may be asked to provide patient name, MRN and scan data specifics before your request is completed.

When choosing your print method, please note:
  • If you choose "unknown," the most cost-effective option will be selected for you.
  • If you choose "other," you will be asked to describe your request. Material jetting (soft models, multiple colors); functional prototypes (strong/durable parts); and metal printed parts are available upon request.
  • Details on print methods are available here.

Grant Program

The grant program will pay for approximately the first 300 qualifying prints. If your request does not qualify for the grant program, a reasonable quote will be established and shared with you for approval.
All produced parts will be photographed and, when applicable, cataloged along with relevant patient-specific information (condition, scan type, demographic info, but not personally identifiable information) to produce a case study. This information will be made available to authorized personnel to identify similar cases when needed. The information will also be used to quantify patient, education and research outcomes through use of this service. By submitting this form, you agree to these terms.