Supporting meaningful breakthroughs in medical science

Some of the most meaningful breakthroughs in medical technology emerge through collaboration. We support educational, charitable, and research endeavors that serve a genuine educational or public health function, benefit society, or that demonstrate good corporate citizenship.

Application for Research, Educational, Charitable Donations and Product Donations from MicroPort CRM

Please use the application form below to apply for all healthcare educational or research grants, charitable monetary donations, or product donations. All requests should be received at least six (6) weeks prior to the date the donation or grant is needed in order to ensure time for review and processing.

If you have any questions or problems, please send an email to donationsandgrants@crm.microport.com.

Due to reported problems related to the use of Safari 11, we suggest you to use a different browser to submit the form.

To request a financial donation or grant, please complete the Application Form below.

Please be prepared to upload one or more of the following:

  • Request letter (signed and on official institution letterhead)
  • Detailed description of event or purpose (on official institution letterhead)
  • Budget and description of how the funds will be applied/used
  • Abstract or study proposal (research grants only)
  • W-9 ( For US)
Type of request: *
Important: Only Healthcare Organizations where Healthcare Professionals are in training are eligible to request and/or receive such Educational Grants

Organization type: *

Organization type: *

Please attach the following documents

Is this Program accredited: *

Please attach the following documents

Is 100% of the requested amount in the relation to the charitable program? *
Are you soliciting other companies?: *

Please attach the following documents

Has your organization received support in the form of a donation or grant from MicroPort CRM in the past? *

Certification

By submitting this application, I acknowledge and agree to the following:

  • The information presented on this form is accurate, true and correct.
  • I am acting under authorization of the organization requesting funding from MicroPort CRM.
  • I confirm that this request is not and will never be tied to the prescription or purchase of MicroPort CRM products or services.

You must receive a confirmation email to the email address you have indicated above; if you do not, it means that your request has not been successfully submitted to MicroPort CRM.

Please note that due to limited funding, not every qualified request will receive funding.

Approval of a grant or donation request will never be tied to the prescription or purchase of our products. We adhere to all applicable laws, regulations and industry codes of conduct in determining our support for any request.

The information collected on this form is digitally processed by the Controller, Sorin CRM SAS, established 4 avenue Réaumur - 92140 Clamart - France. The purpose of processing is solely to evaluate your application in respect to our legitimate interest of and to our legal obligations. The processing does not provide for automated decision making and the MicroPort CRM internal D&Gs Committee is the recipient of the data. Please note that, according to transparency regulations and local codes, we may publish your data to authorities or industry associations. The data are processed with a relevant level of security and no data will ever be transferred outside of the European Union. We will not keep the data in an active database for more than 5 years. As per Data Protection laws, you have the right to access as well as to rectification or to erasure of personal data as well as to withdraw your consent or to oppose or to restriction of processing by contacting the Data Protection Officer at: dpo@crm.microport.com. Should you believe afterwards that your data protection rights have been unlawfully addressed, you may lodge complaint with a Supervisory Authority (i.e. CNIL).

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