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Test your eligibility for FibroScan^® GO

Please complete the form below
and answer the following two questions.

First Name*(Required)

Last Name*(Required)

Email address*(Required)

Institution/Practice name*(Required)

Position*(Required)

Speciality*(Required)

Your institution setting*(Required)

Country*(Required)

Zip code*(Required)

State*(Required)

Phone number

Question 1(Required)

Yes

No

Are you prescribing liver function tests (LFT)?

Question 2(Required)

Less than 20

20-30

30-50

More than 50

If you were to have access to FibroScan, how many exams would you expect to perform per month (including exams performed by yourself or your colleagues)?

Question 3(Required)

Between 0 and 40

Between 40 and 100

More than 100

How many patients do you see per month with at least one of the following risk factors? Type 2 diabetes // BMI>30 // 2+ cardiometabolic risk factors?

(Required)

I agree that Echosens collects and uses my data in accordance with the Privacy Policy.*

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