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REQUEST A TRIAL
The STIL anti-tremor orthosis will become available soon.
Complete the form below and we’ll contact you as soon as possible.
Request a trial
What describes you the best?
I have tremors
I know someone with tremors
I am a medical professional
Enter your details
First name
Last name
Organization
Gender
Male
Female
Other
Age
Email
Phone number (WhatsApp number)
Country
Netherlands
Belgium
Germany
Other
Write down your country
Some questions about your tremors
Tremor disorder (select one)
Essential tremor
Parkinsons
MS
Dystonia
Orthostatic tremor
Cerebral tremor
Physiological tremor
Functional tremor
Other (Please describe in comments section)
Are you diagnosed by a specialist?
Yes
No
In which arm is tremor bothering you the most?
Right
Left
Both
What is your dominant arm?
Right
Left
Other comments
Permission for data use
Yes, I give permission to STIL to use the data entered above according to the
Privacy Policy
.
Keep me up to date
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