Case Model Manufacturer Hands-on Session Form

Flow of the Manufacturer Hands-on Session Request

STEP 1
Please fill in the required information in the "Manufacturer Hands-on Session Details" section of this form.
STEP 2
After submitting the form, you will receive a confirmation email.
STEP 3
We will notify you at the email address provided in the form regarding whether the manufacturer hands-on session can be arranged, within approximately 5 business days. ^⋆1
STEP 4
If the hands-on session is approved, please coordinate the schedule directly with the designated manufacturer. In general, the session can be held within approximately 10 days.

⋆1：You may select your preferred manufacturer from a list of pre-registered medical device manufacturers participating in this service. In some cases, you may receive hands-on session proposals from multiple companies. If no proposals are received, please submit a new request through the "Order/Quotation Request" form for case-specific model production.

Notes on sending case data

In case of file upload

(1)Please prepare an STL-format file converted from DICOM data of a 3D DSA image capturing the affected blood vessels (voxel size recommended to be 0.15 mm or smaller) using a medical imaging workstation, or an open-source software like 3D Slicer. If you have any questions regarding data preparation, please contact us via the "CONTACT" page on our website.
(2)Please ensure that all data is anonymized.
(3)As a general guideline, the model to be created should fit within dimensions of 100mm × 100mm × 70mm (length × width × height), including the affected area.
(4)Please specify the type of device intended for use and provide information that identifies the affected area in the designated fields.
(5)Please ensure that the STL data is a completely closed 3D model before submitting.
(6)Please compress the STL data file in ZIP format. The maximum file size allowed is 200MB.

Manufacturer Hands-on Session Details

Please fill out the following form and select the "Confirm" button.
All fields are required except for a few.

Name of Hospital or Facility /Department

Name of person in charge

E-mail address

Re-enter for confirmation

Phone number (*no hyphen)

Postal code (*no hyphen)

Your Address

State/Province

City/Town/Village

Address below

Building name etc.

Specified Medical Device Manufacturer

Japan Lifeline

Terumo

Device Type You Plan to Use

Specification of Affected Area

Please specify the area and range to be modeled.

File Upload

Please drop your file here
(ZIP format, 200 MB or less)

Uploading may take some time depending on the file size.
Please do not move the file until you see the message "Upload Complete".

Uploading：

Upload completed

Upload error

If the upload does not work, please specify the file from the "Browse" link below.

Use of Personal Information for Case Model Manufacturer Hands-on Session

Blue Practice supports medical specialists in delegating hands-on sessions using case models to medical device manufacturers.
Customers are required to attach case data they wish to model and specify their preferred manufacturer to request a manufacturer hands-on session using vascular models (case models). STL data is transferred to the specified medical device manufacturer. A list of pre-registered manufacturers is provided for customer selection. In some cases, proposals may be received from multiple manufacturers. If no proposals are received, please re-submit an order or estimate request.

Collected Personal Information

The following personal information is required for the manufacturer hands-on application:
• Customer Information: Hospital/facility name and department, contact person’s name, furigana, email address, phone number
• Application Information: Medical device manufacturer, type of device to be used
• Medical Information: STL data, specified lesion site (please specify the region/area to be modeled), date and time of receipt

Purpose of Use of Personal Information

Customer and case information will be used for the following purposes:
• To confirm application details (via phone, email)
• To notify about hands-on availability (via email)
• To contact medical device manufacturers (via phone, email)
• To support the manufacturer hands-on application
• To transfer STL data after application
• To provide information about services
• To improve services

Outsourcing of Personal Information Handling

This form’s website and data transfers use data centers.

Provision of Personal Information to Third Parties

As the case model manufacturer hands-on is a service connecting specialists with manufacturers, STL data will be provided to medical device manufacturers with the customer's consent. Except when legally required, personal information will not be provided to third parties without the customer’s prior consent.

Disclosure, Correction, and Suspension of Use of Personal Information

For disclosure, correction, or suspension of hands-on availability after the manufacturer hands-on application, please contact the representative of the manufacturer to whom the application was submitted.

Complaints and Consultations Regarding Personal Information

For complaints or consultations regarding the handling of personal information in connection with case model manufacturer hands-on applications, please contact the Personal Information Inquiry Desk using the contact form.

Blue Practice Inc.
Plaseo Aoyama Building 3F, 2-7-13 Kita-Aoyama, Minato-ku, Tokyo
Personal Information Protection Officer
Contact Form

I agree to the terms regarding the use of my personal information.