Sciton Cares Registration Form

We want to thank you for your interest in this wonderful program. Sciton Cares is a global network program where we will be helping low-income patients affected by skin vascular lesions or hypertrophic scars caused by burns or trauma.

For vascular lesions, our company has partnered with Dr. Linda Rozell-Shannon, Ph.D., President, and Founder of the Vascular Birthmark Foundation, and Karen Ball, President and CEO of the Sturge Weber Foundation. These two wonderful organizations will help connect us with patients in your area.

We are asking for your commitment to treat 1 to 4 patients over the course of one year, keeping in mind that these patients may require multiple treatments. Please let us know if this is something you are comfortable with or if you have further questions.

Once we have confirmed your commitment, Sciton will provide co-branded content for social media to highlight this partnership. We will also inform the above organizations of your pledge. The Vascular Birthmark Foundation and The Sturge Weber Foundation will provide your information to the qualified candidates.

As part of the Sciton Cares Program, patients will consent to sharing their journey, including before and after pictures, treatment footage, testimonials, etc. We kindly ask for your support in collecting these items as you engage with each patient. Sciton will provide a checklist to help guide this process.

Once again, thank you for your support and partnership with the Sciton Cares Program. Together, we will continue to improve people's lives.

We are extremely excited to be partnering with you on this program.

For any questions, please contact Lina Leon lina.leon@sciton.com

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Email *
Name *
Clinic Name *
Phone Number *
City *
Country *
Please share your preferred email address for communication with qualified treatment candidates.  *
In recognition of your support, Sciton would like to provide a plaque of gratitude for your office, along with access to all Sciton Cares assets for you to utilize. Please list the name of the clinic or physician name to add on the plaque  *
Preferred treatment that you want to offer *
Required
Number of patients that you can commit for a year period (Please keep in mind that these patients may need multiple treatments) *
Required
System Serial Number ( You can find it on the back of your system)
Modalities  *
Required
Additional comments 
Sciton Cares, Changing the world one patient at the time.
A copy of your responses will be emailed to the address you provided.
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