Volunteer Request
Fusion to Schedule Volunteers
Your Name
Please Select
Adriana Simicich
Allison Daniels
Anil Prasad
Cecilia Juarez
Daryl Greaser
Eduardo Ortiz Vasquez
Elizabeth Brunelle
Emily Cai
Gwen Miller
Jackie Sangco Rivera
Jenny Cox
Joyce Grube
Kate Santos
Katelyn Fortier
Krislynn Barnhart
Lauren Peterson
Laurie Cikatz
Lydia Rivera
Michelle Kushman
Rita Chew
Sarah Christiansen
Shannon Fox
Andrew Yoo
Katy Ivanova
Tahiroh Barr
Your Email
example@example.com
Scan Type
Please Select
Breast $150/hr
Testicular/Invasive Male $150/hr
Early OB [Endovaginal] $225 insertion
Non-Invasive OB/Pelvic $75/hr
General non-invasive $75/hr
Endovag/Invasive Fem $150/insertion
Neonatal Head $100/hr
Minor (<18) $100/hr
Endo-rectal $150/ insertion
CANCELLED/NOT SCANNED FEE
Philips Project Number
Please Select
A&OB Clinical Investigations (50006161)
Blaze POC Cart (50006073)
C9-4ec Transducer (50006088)
Compact 2.0 (50006447)
CV Clinical Investigations (50006137)
Feasibility High End Premium Travel/Clinical (50006163)
GI Clinical Investigations (50006162)
Lumify 5.0 (50006087)
Lumify 5.1 (50006106)
Lumify Hummingbird (50006090)
Protego 1.0 (50006061)
Shelby 1.0 High-End OB (50006400)
Sustaining CX50 (50007252)
Sustaining EPIQ for VM Projects (50007248)
Sustaining Lumify (50007247)
US Image Plunkability(50007279)
VM 10.0 (50006075)
VM 10.0.2 (50006724)
VM 11.0 (50006085)
VM 12.0 (50006726)
VM 13.0 (50007554)
VM 9.0.10 (50007235)
VM L4L 10.0.5(50006101)
NOT LISTED CONTACT CRA
Philips Scan Protocol
Please Select
11454 - Development / Optimization Protocol
11526 - Validation Protocol
Does Not Apply
Back
Next
Scan Location
Please Select
Bothell - 22100 Bothell Everett HWY, Bothell, WA
Cambridge - 222 Jacobs Street, Cambridge, MA
Other (Note In Comments)
Scan Date and Start Time
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Shift Length (number of hours needed)
Number of Volunteers Needed?
Specific Gender Needed?
Please Select
Yes - Male
Yes - Female
Yes - Even Mix
No (any gender is fine)
Specific Age Range Requested?
Specific Volunteers Requested?
Is this Training / Demonstration (2X Pay Rate)?
Please Select
Yes
No
Comments or Notes to Scheduling Team (Optional):
Submit
Should be Empty: