Order a patient information kit
Request More Information
Fill out the form below to receive FREE materials about The Prolieve™ System Treatment.
* Indicates required field.

First Name *

Last Name *

Address *

Suite/Apt. Number

City *

State *

ZIP Code *

Telephone Number

E-mail Address *

Confirm E-mail Address*


How did you hear about this site?

My physician
Search engine
Link from another web site
Email newsletter
Banner ad
Don't know


Male Female


Yes No


Yes No

Diagnosed with BPH?

Yes No

If No, then why are you visiting this site? Choices:

I have BPH symptoms.
I am a caregiver to someone with BPH symptoms.
I am a Urologist.
I am a Primary Care Physician.

By checking this box, you agree that Boston Scientific Corp. may contact you regarding new products, services, programs, and materials.