Name *

First Name

Last Name

Phantom Use *

Clinical Trials

Clinical Quality Assurance

Academic Research

Industry Research or Product Development

Other (please provide a description below)

What phantom type are you interested in? *

See our products page for more information

PDFF Phantom Packs^

Comprehensive PDFF 18-Vial Spherical (Model 825)

PDFF 12-Vial Spherical (Model 300)

PDFF 6-Vial Spherical (Model 600)

PDFF-R2* 16-vial Spherical (Model 725)

R2* 12-vial Spherical (Model 300)

R2* 6-vial Spherical (Model 600)

T1 12-vial Spherical (Model 300)

T1 6-vial Spherical (Model 600)

T2 6-vial Spherical (Model 600)

15-vial Spherical with Combination of Vial Types

Custom Spherical Phantom or Custom Phantom Packs

All products are verified at 3T. Do you also want your product(s) verified at 1.5T? *

Yes

No

What type of imaging system do you use? *

Select all that apply

GE

Siemens

Philips

Canon/Toshiba

United Imaging

Other

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