About BPH & Enlarged Prostate Information from Urologix

Request Enlarged Prostate Information
*First Name : 
*Last Name : 
*Company : 
*Title : 
*Practice Specialty : 
*Address : 
*City : 
*State : 
*Zip Code : 
How did you become aware of Cooled ThermoTherapy™?
How many physicians are in your office?
Do you currently treat BPH?
 Yes
 No
How many BPH patients does your practice treat annually?
- Of these, how many are treated with medications?
I am interested in the following: : 
 Information on Targis® System
 Information on Prostatron® System
 Published technical and clinical information about Targis® treatment
 Published technical and clinical information about Prostatron® treatment
 I would like a Urologix Sales Representative to contact me
Additional comments or requests: : 



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