Society Conference 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 or to reward prior purchases, uses, orders, or recommendations of Globus products.

    •All unused product will be returned to Globus Medical, Inc.

    •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 or to reward prior purchases, uses orders, or recommendations of 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.