Contact – BioXTek

Contact Us

Please fill in the following fields as required by FDA and JCAHO and submit to our HIPAA compliant database for tissue tracking purposes... Thank you

Date of implantation or discard(Required)

Reason for discard

Please provide a reason if this allograft is discarded; otherwise, please fill in all fields

Physician Name:(Required)

First Last

Specialty(Required)

Facility Name(Required)

ASC(Required)

Clinic(Required)

Hospital(Required)

City(Required)

State(Required)

Zip/Postal Code(Required)

Office Telephone Number(Required)

Procedure Description or CPT#(Required)

This field is for validation purposes and should be left unchanged.