Information Request


Information Request Form

Using this form, you can request information about any of the BESA products, or request a quotation for any of BESA’s products.

    First Name (*)

     

    Last Name (*)

     

     

     

    Position

     

    Organisation, University

     

     

     

    Department

     

    Country

     

     

     

    Street

     

    Number

     

     

     

    Postal Code

     

    City

     

     

     

    Email (*)

     

    Phone

     

     

     

    What EEG/MEG system are you working with?

     

     

     

    I would like to receive information material about BESA Research.

     

    I would like to receive information material about BESA MRI.

    I would like to receive information material about BESA Statistics.

     

    I would like to receive information material about multimodal imaging / sEEG processing.

     

     

     


    I would like to receive a quotation for the following modules:

    BESA Research Basic

     

    BESA Research Standard

    BESA Research Complete

     

    MEG Analysis

    BESA MRI

     

    BESA Statistics

    BESA Connectivity

     

    Upgrade BESA Research

     

     

     

    I agree to receiving the BESA newsletter which is published approximately once a month. I can unsubscribe from this service at any time by following a link that appears at the end of every newsletter, or by unsubscribing on the page Unsubscribe from Newsletter. Usage of my personal data is described in the Privacy Statement.

     

     

     

    Please verify that you are human by filling out the captcha below
    captcha