Email Request Form

Online portal :: MED-EL USA Marketing

Email ID number

Date requested*

Requested by:*

Reply To (If people have questions/comment about an email, who does marketing send these inquires too?)*

Country*

Canada

United States

Both

Topic: *

I would like this email to go out between*

Which language(s) will this be sent in? *

English Only

English and Spanish

English and French

English, Spanish, and French

Who should be featured in an image? *

Adults

Pediatrics

Both Adults and Pediatrics

Who does this need to be emailed to? *

All Professionals

Audiologists Only

Surgeons and Audiologists Only

Adult BONEBRIDGE Recipients (18 and over)

Pediatric BONEBRIDGE Recipients (Under 18)

Adult CI Recipients (18 and over)

Pediatric CI Recipients (Under 18)

Pediatric ADHEAR Recipients (Under 18)

Adult ADHEAR Recipients (18 and over)

Adult HearPeers (18 and over)

Pediatric HearPeers (Under 18)

Leads

other

Do clinical staff need to be sent this email at the same time marketing sends it?*

Yes

Landing Page (Where do you want your audience to go once they've read the email?)*

(If Events and/or Marketing is still creating a page for you, please type in "TBD". If you do not require a landing page, please type "N/A".)

Landing Page 2 (if applicable)

How many attachments will need to be included in the email (i.e. catalogs, order forms, white papers)? *

(If Marketing and/or QC is still creating attachments for you, that's okay. Please provide the number of attachments you think you will need to be included in the email.)

Attachment (1):

Attachment 3 (if applicable)

Attachment 2 (if applicable)

Attachment 4 (if applicable):

Pictures/Images for Email Use (if applicable)

Body of Email (marketing can help with content, but this information will help form the message)*

Word Verification

*MARKETING WILL SEND THE EMAIL LISTED IN THE “REQUESTED BY“ FIELD A DRAFT OF THE EMAIL WITHIN 2-4 WEEKS.

**NOTE: PLEASE CHECK YOUR SPAM FOLDER IF YOU DO NOT RECEIVE YOUR EMAIL CONFIRMATION

Questions?

You can reach out to the Marketing Team for any questions or additional input. We are happy to help!

Creative

Jeff Campagna

Social Media

Justin Kimball

Fulfillment

Kristen Althaus

Events

Lauren Smith