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Genesys HTA™ Physician Finder Form

Register to join the Boston Scientific Gynecologic Surgery Physician Finder

Thank you for your interest in Boston Scientific’s gynecologic surgery treatment options. The information you provide below enables Boston Scientific to add your name and practice information to the physician finder on the BostonScientific.com website. You may be contacted by potential patients with questions about your practice and Boston Scientific’s minimally-invasive treatment options, the Genesys HTA™ and/or the Symphion System. Your addition to the physician finder is free of charge and no financial incentives are offered.

Qualifications: Our physician finder consists of physicians who are Gynecologists, Surgical Gynecologists, Urogynecologists and Urologists who have diagnostic hysteroscopy training and are willing to consider accepting patient referrals from the website listed above and may be experienced with Boston Scientific products.  If approved, Boston Scientific will add your name, address and contact information to our physician finder and website referral lists.

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 The Genesys HTA™ System
 The Symphion™ System
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*Information requested in this section is for internal use only and will not be shared outside of Boston Scientific.

How many procedures do you complete each month with the following products:

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(Please type your full name)
 
 

I hereby authorize Boston Scientific Corporation to include my name, affiliation, and practice information in the PHYSICIAN FINDER option found on its company-sponsored website, www.BostonScientific.com.  I understand that my inclusion in the PHYSICIAN FINDER is based solely on meeting the eligibility requirements described on this form and that by including my information in the PHYSICIAN FINDER, Boston Scientific is not endorsing or recommending my medical practice to patients.

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