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The Steadi-Two 10 Second Eligibility Assessment
Welcome to the 10 Second Assessment Form by Steadiwear. We look forward to learning more about your specific tremor. Kindly note that by filling in this form, you are allowing us to contact you by email or phone to follow-up on your case or update you of Steadiwear's latest news.
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What is your name *
What is your email *
What type of tremor do you have? *
Where are you tremors sourcing from *
Do your tremors look like this?
Do you have a pacemaker or have you undergone Deep Brain Stimulation? *
Are you interested in the 30-day trial of the Steadi-Two *
What is your phone number? *
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