First Name*Last Name*Institution/Organization*TelephoneEmail Address* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingWhat current data management system(s) are you using? (Choose all that apply) Abbott PrecisionWeb™ RALS™ Web3 CGM LABDAQ® IL GEMweb® Plus Orchard® Trellis™ Radiometer AQURE Radiometer Radiance Roche cobas® IT 1000 SIEMENS POCcelerator™ SIEMENS RapidComm® SIEMENS UniPOC™ Telcor QML® Other If other, please indicate below*Request Type I’d like to schedule a RALS Web3 demonstration I’d like to access the new RALS User Interface demo system Comments*