Online Design Form - FMA 36-ch (STD/HD)

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Contact Information

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GENERAL SPECIFICATIONS

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Please attach description of desired configuration below. If different types or layouts of array are desired within the same combo implant, please submit a different design form for each and add explanation for each file.
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Array Impedance, Length, and Pin-Out Mapping

Assign pin location according to your system

Table 1

From hole #1 to hole #18
For arrays where all electrodes are less than 2mm long, the reference and the ground electrodes should be a minimun of 2.5mm long. This will help provide ample anchoring of the FMA in the tissue
FMA Hole# Pin # Impedance(MΩ) Length (mm)
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Numeric Value
Numeric Value
Numeric Value
2
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Numeric Value
Numeric Value
3
Numeric Value
Numeric Value
Numeric Value
4
Invalid Input
Numeric Value
Numeric Value
5
Numeric Value
Numeric Value
Numeric Value
6
Numeric Value
Numeric Value
Numeric Value
7
Numeric Value
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Numeric Value
8
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Numeric Value
Numeric Value
9
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10
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11
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Numeric Value
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12
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13
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14
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15
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16
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17
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Numeric Value
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Numeric Value

Table 2

From hole #19 to hole #36
For arrays where all electrodes are less than 2mm long, the reference and the ground electrodes should be a minimun of 2.5mm long. This will help provide ample anchoring of the FMA in the tissue
FMA Hole# Pin # Impedance (MΩ) Length (mm)
Invalid Input
Numeric Value
Numeric Value
Numeric Value
20
Numeric Value
Numeric Value
Numeric Value
21
Numeric Value
Numeric Value
Numeric Value
22
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Numeric Value
Numeric Value
23
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Numeric Value
Numeric Value
24
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Numeric Value
25
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26
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27
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28
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29
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30
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31
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32
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33
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34
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35
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Numeric Value
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Numeric Value

Accessories and Additional Services

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Your custom design and layout sheet

If your requested design cannot be fully described by the questions above, please attach a description here. Make drawing as clear as possible:

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Application Description (Optional)

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About Your Order

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See Terms and Conditions for details
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