a. Screening 1 + Consent

Elidah Male SUI Study

Thank you for your interest in participating in our clinical study. Please fill out the form below to see if you are eligible.

Full Name *

Email *

Phone Number *

Date of Birth *

Date of scheduled laparoscopic prostatectomy *

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What is your height in inches? *

60

72

84

What is your weight in pounds? *

What is your BMI? *