Grants Application

surgeon with device
  • Date Format: MM slash DD slash YYYY
  • Date Format: MM slash DD slash YYYY
    • The funds will be used only for the intended purpose of this request and will not be used in violation of any State or Federal Laws.
    • No Globus employee implicitly or explicitly offered a contribution to induce the Recipient its personnel, or me to purchase, use, order or recommend Globus products.
    • The funds awarded will not be used in violation of any healthcare code of ethics.
    • Globus Medical reserves the right to request the return of award at any time upon failure to comply with procedures and legal regulations.
    • All information included on and documentation attached to this request form by the Requestor and/ or Recipient is accurate.