FMA 18-ch (STD/HD) Electrode Array

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Name on Quote (if not contact person):

GENERAL SPECIFICATIONS

Provide us with the brand and model of your recording and/or stimulation system and headstage

Number of channels in Array (excluding reference and ground)

Metal Type

Tip exposure type

Please select array spacing (Standard or HD)

Layout

Standard FMA 36-ch

Array hole layout and designation, viewed throught the tails of the electrodes

High Density FMA 36-ch

Array hole layout and designation, viewed throught the tails of the electrodes

Please select lead exit orientation off array

Please select connector configuration

Do you require multiple arrays to come off of the same connector or pedestal?

Please attach description of desired configuration to the Custom Design and Layout Sheet entry 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 to Custom Design and Layout Sheet.

File Upload

Click or drag a file to this area to upload.

Do you need special array or cable modifications, such as for peripheral nerve, in-vitro applications, or high mobility?

Please describe desired modification:

(c) Cable Length between array and connector

ARRAY IMPEDANCE, LENGTH, AND PIN-OUT MAPPING

Assign pin location according to your system

Layout

FMA Hole#

FMA Hole

Pin #

Impedance(MΩ)

MΩ

Length (mm)

Layout 2

FMA Hole

MΩ

Length (mm)

Layout (copy) (copy)

FMA Hole

MΩ

Length (mm)

Layout 4

FMA Hole

MΩ

Length (mm)

Layout 4 (copy)

FMA Hole

MΩ

Length (mm)

Layout 6

FMA Hole

MΩ

Length (mm)

Layout 7

FMA Hole

MΩ

Length (mm)

Layout 8

FMA Hole

MΩ

Length (mm)

Layout 9

FMA Hole

MΩ

Length (mm)

Layout 10

FMA Hole

MΩ

Length (mm)

Layout 11

FMA Hole

MΩ

Length (mm)

Layout 12

FMA Hole

MΩ

Length (mm)

Layout 12 (copy)

FMA Hole

MΩ

Length (mm)

Layout 14

FMA Hole

MΩ

Length (mm)

Layout 15

FMA Hole

MΩ

Length (mm)

Layout 15 (copy)

FMA Hole

MΩ

Length (mm)

Layout 15 (copy) (copy)

FMA Hole

MΩ

Length (mm)

Layout

FMA Hole

MΩ

Length (mm)

ACCESSORIES AND ADDITIONAL SERVICES

Do you need Kwik-Sil for the surgery?

Yes
No

Please specify quantity

Do you require product pre-sterilization?

Yes
No

Sterilization (ethylene oxide gas) will be performed by a third party and requires an additional fee to cover process, packaging, and shipping. Typical fee is $850 USD per batch. Process is not validated for human use.)

Pedestal

Units

FMA Vacuum Insertion Kit

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:

File Upload

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APPLICATION DESCRIPTION (OPTIONAL)

The following questions can help our sales team assist you in optimal probe selection and design.

Animal Model / Application:

Implant Location / Usage Description:

Layout

Acute or Chronic Use:

Functionality

ABOUT YOUR ORDER

How many of this FMA design do you wish to order?

Delivery options

Standard 6 weeks delivery
Rush order

Special requirements