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</h1> <div class="score-hero-body"> <!-- XhtmlString.cshtml Display Template Start --> <p>Whether you need expert opinions based on files, with examination or related to care – rely on medical risk assessments for well-founded decisions and risk management.</p> <!-- XhtmlString.cshtml Display Template End --> </div> <div class="score-call-to-action"> <a href="/en-de/products/medical-expert-assessments/#contact" target="_self" class="score-button verisk-button primary md" title="Contact us" > <div class="inner-content-wrapper"> <span class="button-title">Contact us<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg> </span> </span> </div> </a> </div> </div> </div> </div> </div> </div> <div class="[ grid__item grid__item__full ] [ full-bleed ] " id="block-117840"> <section class="score-stripe flexible-stripe no-bg-image-on-mobile bg-default " style="" data-epi-type="content"> <div class="container justify-center"> <div class="w-full"> <div class="section-header justify-center"> <H2 class=""> Medical expertise taking centre stage </H2> <div class="subtitle rich-text justify-center"> <!-- XhtmlString.cshtml Display Template Start --> <p>In complex bodily injury or benefit cases, the insurance company's medical knowledge and experience is often not sufficient. An additional objective medical assessment is therefore advisable.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> </section> </div> <div class="card-stripe-container [ grid__item grid__item__full ] [ full-bleed ] bg-default columns-three" id="block-117847" > <section class="score-stripe slim-no-image-cards no-bg-image-on-mobile " style="" data-epi-type="content"> <div class="pagination-target"></div> <div class="container justify-center"> <div class="w-full"> <div class="section-header justify-center"> <H2 class=""> Making informed decisions based on medical assessments </H2> <div class="subtitle rich-text justify-center"> <!-- XhtmlString.cshtml Display Template Start --> <p>If your medical and care expertise reaches its limits, we offer and arrange any form of medical assessment – whether on the basis of files or with a physical examination.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="content-area justify-center"> <div class="card-container stripe-card-column"> <div class="score-card primary slim slim-without-image verisk-default featured bg-primary-radical-blue" id="block-117849"> <div class="caption"> <H2 class="card__title"> Objective risk management </H2> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>With the medical assessment of claims by medical experts, your decisions rest on a well-founded basis.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> </div> <div class="card-container stripe-card-column"> <div class="score-card primary slim slim-without-image verisk-default featured bg-primary-radical-blue" id="block-117852"> <div class="caption"> <H2 class="card__title"> 20+ specialties </H2> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>With our network of assessors, you can rely on experts from numerous medical and care disciplines.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> </div> <div class="card-container stripe-card-column"> <div class="score-card primary slim slim-without-image verisk-default featured bg-primary-radical-blue" id="block-117853"> <div class="caption"> <H2 class="card__title"> Digital mediation and commissioning </H2> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>With the digital appraisal platform, you can commission and manage appraisals easily and securely – and thus reduce your administrative workload.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> </div> </div> </div> </div> <div class="blog-pagination"> </div> </section> </div> <div class="[ grid__item grid__item__full ] [ full-bleed ]"> <section style="" class="section-hero-block-container no-bg-image-on-mobile bg- bg-alt-white-3 circular-image"> <div class="container justify-center"> <div class="w-full"> <div class="content-area"> <div class="section-hero-block"> <div class="page-layout w-7col"> <div class="score-section-hero"> <h2 class=""> Types of expert assessments </h2> <div class="score-hero-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <ul> <li>Expert opinions based on files</li> <li>Expert opinions with examination</li> <li>Care reports</li> <li>Medical future damage</li> <li>Assessment of degree of disability</li> <li>Medical case conferences</li> </ul> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> <div class="page-layout image-wrapper w-5col"> <div class="score-section-hero"> <h2 class=""> Types of expert assessments </h2> </div> <img src="/4a5e23/contentassets/1dd2fe7cefa2446eb3328834301cf34d/man-standing-in-front-of-medical-wall-charts.jpg/_croppings/gray-scarf-round.jpg" alt="Man Standing In Front Of Medical Wall Charts " loading="lazy" class="score-image "> </div> </div> </div> </div> </div> </section> </div> <div class="[ grid__item grid__item__full ] [ full-bleed ] " id="block-117856"> <section class="score-stripe flexible-stripe no-bg-image-on-mobile bg-default " style="" data-epi-type="content"> <div class="container justify-center"> <div class="w-full"> <div class="section-header justify-center"> <H2 class=""> Customer specific management of expert opinions:<br>Navigate through the assessment jungle </H2> <div class="subtitle rich-text justify-center"> <!-- XhtmlString.cshtml Display Template Start --> <p>Expert opinions can be ordered and managed easily and securely via a digital expert opinion platform. Comprehensive filter options allow you to identify suitable medical experts from numerous specialist fields. Orders, communication, documents, invoices – you will find everything in one place thanks to standardized processes. This reduces the administrative workload for everyone involved.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="cta justify-center"> <a href="/en-de/products/digital-assessors-platform/" target="_self" class="score-button verisk-button primary md" title="Learn more about the Digital Assessor's Platform" > <div class="inner-content-wrapper"> <span class="button-title">Learn more about the Digital Assessor's Platform<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg> </span> </span> </div> </a> </div> </div> </div> </section> </div> <div class="[ grid__item grid__item__full ] [ full-bleed ]"> <section style="" class="section-hero-block-container no-bg-image-on-mobile media-left bg- bg-alt-white-3 circular-image"> <div class="container justify-center"> <div class="w-full"> <div class="content-area"> <div class="section-hero-block"> <div class="page-layout w-7col"> <div class="score-section-hero"> <h2 class=""> Where we support you with medical assessments </h2> <div class="score-hero-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <ul> <li>Motor liability insurance</li> <li>General liability insurance</li> <li>Hospital and medical liability insurance</li> <li>Private accident insurance</li> <li>Life insurance and occupational disability insurance</li> <li>Long-term care insurance</li> <li>Private health insurance</li> <li>Law firms</li> <li>and more</li> </ul> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> <div class="page-layout image-wrapper w-5col"> <div class="score-section-hero"> <h2 class=""> Where we support you with medical assessments </h2> </div> <img src="/4a78e3/contentassets/a3df2d7dfe36493bb9d5428d871dbe7b/two-men-reviewing-laptop.jpg/_croppings/gray-scarf-round.jpg" alt="Two Men Reviewing Laptop " loading="lazy" class="score-image "> </div> </div> </div> </div> </div> </section> </div> <div class="[ grid__item grid__item__full ] [ full-bleed ]"> <section style="background-image: url('');" class="section-hero-block-container no-bg-image-on-mobile bg- bg-primary-global-blue no-media"> <div class="container justify-center"> <div class="w-full"> <div class="content-area"> <div class="section-hero-block"> <div class="page-layout w-8col"> <div class="score-section-hero"> <h2 class=""> Reimagine expert-based medical assessment now </h2> <div class="score-hero-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>Download the product flyer with all information at a glance. </p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> </div> </div> <div class="page-layout w-4col"> <div class="score-section-hero"> <div class="score-call-to-action"> <a href="/4a7223/siteassets/global/de-de/fundierte-entscheidungen-basierend-auf-medizinischen-bewertungen-treffen.pdf" target="_blank" class="score-button verisk-button primary md" title="Learn more" > <div class="inner-content-wrapper"> <span class="button-title">Learn more<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg> </span> </span> </div> </a> </div> </div> </div> </div> </div> </div> </div> </section> </div> <div class="card-stripe-container [ grid__item grid__item__full ] [ full-bleed ] bg-default columns-three" id="block-117842" > <section class="score-stripe standard-cards no-bg-image-on-mobile " style="" data-epi-type="content"> <div class="pagination-target"></div> <div class="container justify-center"> <div class="w-full"> <div class="section-header justify-center"> <H2 class=""> Reimagine your claims management </H2> <div class="subtitle rich-text justify-center"> <!-- XhtmlString.cshtml Display Template Start --> <p>Optimise the entire claims management process with our full suite of solutions.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="content-area justify-center"> <div class="card-container stripe-card-column"> <div class="score-card primary horizontal standard featured" id=""> <div class="image-wrapper"> <a href="/en-de/products/digital-assessors-platform/" aria-label="Commissioning medical assessments quickly and securely" target="_self"> <img src="/4a5e97/contentassets/fa2f5ac37e6841009ab03023a5359a2e/doctor-reviewing-records-on-a-tablet.jpg/_croppings/product-detail-page-standard-card.jpg" loading="lazy" class="score-image img-fluid" alt="Doctor Reviewing Records On A Tablet "> </a> </div> <div class="caption"> <a href="/en-de/products/digital-assessors-platform/" alt="Commissioning medical assessments quickly and securely" target="_self"> <H4 class="card__title"> Commissioning medical assessments quickly and securely </H4> </a> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>The digital assessor’s platform connects insurers and other clients directly with medical experts. It is used to quickly and easily commission and manage expert opinions based on files or with an examination.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="score-call-to-action" > <a aria-label="Learn about Digital Assessor’s Platform" class="score-button verisk-button score-button verisk-button tertiary md" href="/en-de/products/digital-assessors-platform/" rel="noreferrer" target="_self"><div class="inner-content-wrapper"><span class="button-title">Learn about Digital Assessor’s Platform<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg></span></span></div></a> </div> </div> </div> </div> <div class="card-container stripe-card-column"> <div class="score-card primary horizontal standard featured" id=""> <div class="image-wrapper"> <a href="/en-de/products/medical-invoice-check/" aria-label="Rely on experts for a professional and thorough invoice check" target="_self"> <img src="/4a78a0/contentassets/46752f82f52d46488935614c08bc3263/medical-invoice-check-computer.jpg/_croppings/product-detail-page-standard-card.jpg" loading="lazy" class="score-image img-fluid" alt="Medical Invoice Check Computer "> </a> </div> <div class="caption"> <a href="/en-de/products/medical-invoice-check/" alt="Rely on experts for a professional and thorough invoice check" target="_self"> <H4 class="card__title"> Rely on experts for a professional and thorough invoice check </H4> </a> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>By systematically reviewing medical invoices for bodily injury claims, we enable an objective assessment of risks and potential reductions in claims and benefits settlement – as your medical back office.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="score-call-to-action" > <a aria-label="Learn about Medical Invoice Check" class="score-button verisk-button score-button verisk-button tertiary md" href="/en-de/products/medical-invoice-check/" rel="noreferrer" target="_self"><div class="inner-content-wrapper"><span class="button-title">Learn about Medical Invoice Check<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg></span></span></div></a> </div> </div> </div> </div> <div class="card-container stripe-card-column"> <div class="score-card primary horizontal standard featured" id=""> <div class="image-wrapper"> <a href="/en-de/products/claims-benefits-settlement/" aria-label="Let specialists settle your claims efficiently and expertly" target="_self"> <img src="/4a66d6/contentassets/d5c0bcdbd3c84844a7f506088db7b269/row-of-customer-service-workers-with-headsets.jpg/_croppings/product-detail-page-standard-card.jpg" loading="lazy" class="score-image img-fluid" alt="Row Of Customer Service Workers With Headsets "> </a> </div> <div class="caption"> <a href="/en-de/products/claims-benefits-settlement/" alt="Let specialists settle your claims efficiently and expertly" target="_self"> <H4 class="card__title"> Let specialists settle your claims efficiently and expertly </H4> </a> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>Our teams of experts support the claims and benefits settlement of various insurance lines to the desired level of integration: from selective relief of certain activities to case-closing settlement of bodily injury, motor and property claims.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="score-call-to-action" > <a aria-label="Learn about Claims and Benefits Settlement" class="score-button verisk-button score-button verisk-button tertiary md" href="/en-de/products/claims-benefits-settlement/" rel="noreferrer" target="_self"><div class="inner-content-wrapper"><span class="button-title">Learn about Claims and Benefits Settlement<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg></span></span></div></a> </div> </div> </div> </div> <div class="card-container stripe-card-column"> <div class="score-card primary horizontal standard featured" id=""> <div class="image-wrapper"> <a href="/en-de/products/claims-agent/" aria-label="Higher productivity frees up capacity for essential activities" target="_self"> <img src="/4a7c6a/contentassets/8606e32c6c9e4454aa0b33a449bccce4/professional-reviewing-data-on-screen.jpg/_croppings/product-detail-page-standard-card.jpg" loading="lazy" class="score-image img-fluid" alt="Professional Reviewing Data On Screen "> </a> </div> <div class="caption"> <a href="/en-de/products/claims-agent/" alt="Higher productivity frees up capacity for essential activities" target="_self"> <H4 class="card__title"> Higher productivity frees up capacity for essential activities </H4> </a> <div class="score-card-body"> <div class="rich-text"> <!-- XhtmlString.cshtml Display Template Start --> <p>Smart assistants turn complex medical or legal documents into clear, structured case summaries – in just minutes.</p> <!-- XhtmlString.cshtml Display Template End --> </div> </div> <div class="score-call-to-action" > <a aria-label="Learn about Claims Agent" class="score-button verisk-button score-button verisk-button tertiary md" href="/en-de/products/claims-agent/" rel="noreferrer" target="_self"><div class="inner-content-wrapper"><span class="button-title">Learn about Claims Agent<span class="button-svg-wrapper"> <svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 320 512" class="icon"> <path fill="#000000" d="M310.6 233.4c12.5 12.5 12.5 32.8 0 45.3l-192 192c-12.5 12.5-32.8 12.5-45.3 0s-12.5-32.8 0-45.3L242.7 256 73.4 86.6c-12.5-12.5-12.5-32.8 0-45.3s32.8-12.5 45.3 0l192 192z"> </path> </svg></span></span></div></a> </div> </div> </div> </div> </div> </div> </div> <div class="blog-pagination"> </div> </section> </div> <div class="[ grid__item grid__item__full ] [ full-bleed ] " id="contact"> <section class="score-stripe flexible-stripe no-bg-image-on-mobile bg-default " style="" data-epi-type="content"> <div class="container justify-center"> <div class="w-full"> <div class="section-header justify-center"> <H2 class=""> Contact us to learn more </H2> </div> <div class="content-area justify-center"><div class=" w-8col"> <form method="post" 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required.\",\"validationCssClass\":\"ValidationRequired\",\"additionalAttributes\":{\"required\":\"\",\"aria-required\":\"true\"}}}]},{\"targetElementName\":\"__field_120087\",\"targetElementId\":\"9f43379c-1926-4a73-b6fb-ceef8fd9ad26\",\"validators\":[{\"type\":\"EPiServer.Forms.Implementation.Validation.RequiredValidator\",\"description\":null,\"model\":{\"message\":\"This field is required.\",\"validationCssClass\":\"ValidationRequired\",\"additionalAttributes\":{\"required\":\"\",\"aria-required\":\"true\"}}}]},{\"targetElementName\":\"__field_35084\",\"targetElementId\":\"b885ebd3-5ad2-422c-9af2-3811ed8d00c2\",\"validators\":[{\"type\":\"EPiServer.Forms.Samples.Implementation.Validation.RecaptchaValidator\",\"description\":null,\"model\":{\"message\":\"Invalid reCAPTCHA value, please try again.\",\"validationCssClass\":null,\"additionalAttributes\":null}}]}]"), // Steps information for driving multiple-step Forms. StepsInfo : { Steps: [{"index":0,"attachedUrl":"","dependField":null,"dependCondition":null,"isActive":true,"attachedContentLink":"","dependValue":"","elementName":"__field_","guid":"00000000-0000-0000-0000-000000000000"}] }, FieldsExcludedInSubmissionSummary: [], ElementsInfo: JSON.parse("{\"__field_35078\":{\"type\":\"EPiServer.Forms.Implementation.Elements.TextboxElementBlock\",\"friendlyName\":\"firstName\",\"customBinding\":false},\"__field_35079\":{\"type\":\"EPiServer.Forms.Implementation.Elements.TextboxElementBlock\",\"friendlyName\":\"lastName\",\"customBinding\":false},\"__field_35080\":{\"type\":\"EPiServer.Forms.Implementation.Elements.TextboxElementBlock\",\"friendlyName\":\"emailAddress\",\"customBinding\":false},\"__field_35082\":{\"type\":\"EPiServer.Forms.Implementation.Elements.TextboxElementBlock\",\"friendlyName\":\"company\",\"customBinding\":false},\"__field_35081\":{\"type\":\"EPiServer.Forms.Implementation.Elements.TextboxElementBlock\",\"friendlyName\":\"title\",\"customBinding\":false},\"__field_120087\":{\"type\":\"EPiServer.Forms.Implementation.Elements.SelectionElementBlock\",\"friendlyName\":\"country\",\"customBinding\":false},\"__field_120106\":{\"type\":\"EPiServer.Forms.Implementation.Elements.TextareaElementBlock\",\"friendlyName\":\"comments\",\"customBinding\":false},\"__field_35117\":{\"type\":\"EPiServer.Forms.Implementation.Elements.SubmitButtonElementBlock\",\"friendlyName\":\"Submit\",\"customBinding\":false}}"), DataSubmitController: "/EPiServer.Forms/DataSubmit", }; /// TECHNOTE: Calculation at FormInfo level, and these values will be static input for later processing. workingFormInfo.StepsInfo.FormHasNoStep_VirtualStepCreated=true; // this FLAG will be true, if Editor does not put any FormStep. Engine will create a virtual step, with empty GUID workingFormInfo.StepsInfo.FormHasNothing=false; // this FLAG will be true if FormContainer has no element at all workingFormInfo.StepsInfo.AllStepsAreNotLinked=true; // this FLAG will be true, if all steps all have contentLink= ="" (emptyString) })(); </script> <input type="hidden" class="Form__Element Form__SystemElement FormHidden FormHideInSummarized" name="__FormName" value="GLB: glb-de-clm-sales-support-1257" data-f-type="hidden" autocomplete="off" /> <input type="hidden" class="Form__Element Form__SystemElement FormHidden FormHideInSummarized" name="__FormGuid" value="0e9c223f-3878-4a09-a56d-d4b0af0aceb6" data-f-type="hidden" autocomplete="off" /> <input type="hidden" class="Form__Element Form__SystemElement FormHidden FormHideInSummarized" name="__FormHostedPage" value="115720" data-f-type="hidden" autocomplete="off" /> <input type="hidden" class="Form__Element Form__SystemElement FormHidden FormHideInSummarized" name="__FormLanguage" value="en-DE" data-f-type="hidden" autocomplete="off" /> <input type="hidden" class="Form__Element Form__SystemElement FormHidden FormHideInSummarized" name="__FormCurrentStepIndex" value="0" data-f-type="hidden" autocomplete="off" /> <input type="hidden" class="Form__Element Form__SystemElement FormHidden FormHideInSummarized" name="__FormSubmissionId" value="" data-f-type="hidden" autocomplete="off" /> <div class="Form__Status"> <div role="alert" aria-live="polite" class="Form__Status__Message hide" data-f-form-statusmessage> </div> </div> <div data-f-mainbody class="Form__MainBody"> <section id="52e616b1-3468-44c8-a5c2-edd87e3f70a4" data-f-type="step" data-f-element-name="__field_" class="Form__Element FormStep Form__Element--NonData " data-f-stepindex="0" data-f-element-nondata> <!-- Each FormStep groups the elements below it til the next FormStep --> <div class=" "> <div class="Form__Element FormTextbox ValidationRequired" data-f-element-name="__field_35078" data-f-type="textbox"> <label for="c3d65aff-af7b-4496-aa59-65011b2a2914" class="Form__Element__Caption">First Name</label> <input name="__field_35078" id="c3d65aff-af7b-4496-aa59-65011b2a2914" type="text" class="FormTextbox__Input" aria-describedby="__field_35078_desc" placeholder="First Name" required aria-required="true" data-f-datainput autocomplete="off"/> <span class="Form__Element__ValidationError" data-f-linked-name="__field_35078" data-f-validationerror="" id="__field_35078_desc" role="alert" style="display:none"></span></div></div><div class=" "> <div class="Form__Element FormTextbox ValidationRequired" data-f-element-name="__field_35079" data-f-type="textbox"> <label for="b866e49a-ba5f-41c1-bffc-cafc7e7e7fee" class="Form__Element__Caption">Last Name</label> <input name="__field_35079" id="b866e49a-ba5f-41c1-bffc-cafc7e7e7fee" type="text" class="FormTextbox__Input" aria-describedby="__field_35079_desc" placeholder="Last Name" required aria-required="true" data-f-datainput autocomplete="off"/> <span class="Form__Element__ValidationError" data-f-linked-name="__field_35079" data-f-validationerror="" id="__field_35079_desc" role="alert" style="display:none"></span></div></div><div class=" "> <div class="Form__Element FormTextbox ValidationRequired" data-f-element-name="__field_35080" data-f-type="textbox"> <label for="33a8c375-9386-4c39-aa8b-4236bceb44ae" class="Form__Element__Caption">Business Email</label> <input name="__field_35080" id="33a8c375-9386-4c39-aa8b-4236bceb44ae" type="text" class="FormTextbox__Input" aria-describedby="__field_35080_desc" placeholder="Business Email" required aria-required="true" data-f-datainput autocomplete="off"/> <span class="Form__Element__ValidationError" data-f-linked-name="__field_35080" data-f-validationerror="" id="__field_35080_desc" role="alert" style="display:none"></span></div></div><div class=" "> <div class="Form__Element FormTextbox ValidationRequired" data-f-element-name="__field_35082" data-f-type="textbox"> <label for="d6c214b8-683c-4b6c-a2d8-d58ea009a64e" class="Form__Element__Caption">Company</label> <input name="__field_35082" id="d6c214b8-683c-4b6c-a2d8-d58ea009a64e" type="text" class="FormTextbox__Input" aria-describedby="__field_35082_desc" placeholder="Company" required aria-required="true" data-f-datainput autocomplete="off"/> <span class="Form__Element__ValidationError" data-f-linked-name="__field_35082" data-f-validationerror="" id="__field_35082_desc" role="alert" style="display:none"></span></div></div><div class=" "> <div class="Form__Element FormTextbox ValidationRequired" data-f-element-name="__field_35081" data-f-type="textbox"> <label for="7c6009d9-8d06-4151-9e35-1c1ebd40d9fb" class="Form__Element__Caption">Title</label> <input name="__field_35081" id="7c6009d9-8d06-4151-9e35-1c1ebd40d9fb" type="text" class="FormTextbox__Input" aria-describedby="__field_35081_desc" placeholder="Title" required aria-required="true" data-f-datainput autocomplete="off"/> <span class="Form__Element__ValidationError" data-f-linked-name="__field_35081" data-f-validationerror="" id="__field_35081_desc" role="alert" style="display:none"></span></div></div><div class=" "> <div class="Form__Element FormSelection ValidationRequired" data-f-element-name="__field_120087" data-f-type="selection"> <label for="9f43379c-1926-4a73-b6fb-ceef8fd9ad26" class="Form__Element__Caption">Country</label> <select name="__field_120087" id="9f43379c-1926-4a73-b6fb-ceef8fd9ad26" required aria-required="true" data-f-datainput aria-describedby="__field_120087_desc" autocomplete="off"> <option disabled="disabled" value=""> -- Select an option -- </option> <option value="DE" selected data-f-default-value="true" data-f-datainput>Germany</option> <option value="US" data-f-datainput>United States</option> <option value="GB" data-f-datainput>United Kingdom</option> <option value="AF" data-f-datainput>Afghanistan</option> <option value="AL" data-f-datainput>Albania</option> <option value="DZ" data-f-datainput>Algeria</option> <option value="AS" data-f-datainput>American Samoa</option> <option value="AD" data-f-datainput>Andorra</option> <option value="AO" data-f-datainput>Angola</option> <option value="AI" data-f-datainput>Anguilla</option> <option value="AQ" data-f-datainput>Antarctica</option> <option value="AG" data-f-datainput>Antigua and Barbuda</option> <option value="AR" data-f-datainput>Argentina</option> <option value="AM" data-f-datainput>Armenia</option> <option value="AW" data-f-datainput>Aruba</option> <option value="AU" data-f-datainput>Australia</option> <option value="AT" data-f-datainput>Austria</option> <option value="AZ" data-f-datainput>Azerbaijan</option> <option value="BS" data-f-datainput>Bahamas</option> <option value="BH" data-f-datainput>Bahrain</option> <option value="BD" data-f-datainput>Bangladesh</option> <option value="BB" data-f-datainput>Barbados</option> <option value="BY" data-f-datainput>Belarus</option> <option value="BE" data-f-datainput>Belgium</option> <option value="BZ" data-f-datainput>Belize</option> <option value="BJ" data-f-datainput>Benin</option> <option value="BM" data-f-datainput>Bermuda</option> <option value="BT" data-f-datainput>Bhutan</option> <option value="BO" data-f-datainput>Bolivia</option> <option value="BA" data-f-datainput>Bosnia and Herzegovina</option> <option value="BW" data-f-datainput>Botswana</option> <option value="BR" data-f-datainput>Brazil</option> <option value="IO" data-f-datainput>British Indian Ocean Territory</option> <option value="BN" data-f-datainput>Brunei Darussalam</option> <option value="BG" data-f-datainput>Bulgaria</option> <option value="BF" data-f-datainput>Burkina Faso</option> <option value="BI" data-f-datainput>Burundi</option> <option value="KH" data-f-datainput>Cambodia</option> <option value="CM" data-f-datainput>Cameroon</option> <option value="CA" data-f-datainput>Canada</option> <option value="CV" data-f-datainput>Cape Verde</option> <option value="KY" data-f-datainput>Cayman Islands</option> <option value="CF" data-f-datainput>Central African Republic</option> <option value="TD" data-f-datainput>Chad</option> <option value="CL" data-f-datainput>Chile</option> <option value="CN" data-f-datainput>China</option> <option value="CX" data-f-datainput>Christmas Island</option> <option value="CC" data-f-datainput>Cocos (Keeling) Islands</option> <option value="CO" data-f-datainput>Colombia</option> <option value="KM" data-f-datainput>Comoros</option> <option value="CG" data-f-datainput>Congo</option> <option value="CD" data-f-datainput>Congo (RD)</option> <option value="CK" data-f-datainput>Cook Islands</option> <option value="CR" data-f-datainput>Costa Rica</option> <option value="CI" data-f-datainput>Cote d'Ivoire</option> <option value="HR" data-f-datainput>Croatia</option> <option value="CU" data-f-datainput>Cuba</option> <option value="CY" data-f-datainput>Cyprus</option> <option value="CZ" data-f-datainput>Czech Republic</option> <option value="DK" data-f-datainput>Denmark</option> <option value="DJ" data-f-datainput>Djibouti</option> <option value="DM" data-f-datainput>Dominica</option> <option value="DO" data-f-datainput>Dominican Republic</option> <option value="EC" data-f-datainput>Ecuador</option> <option value="EG" data-f-datainput>Egypt</option> <option value="SV" data-f-datainput>El Salvador</option> <option value="GQ" data-f-datainput>Equatorial Guinea</option> <option value="ER" data-f-datainput>Eritrea</option> <option value="EE" data-f-datainput>Estonia</option> <option value="ET" data-f-datainput>Ethiopia</option> <option value="FK" data-f-datainput>Falkland Islands</option> <option value="FO" data-f-datainput>Faroe Islands</option> <option value="FJ" data-f-datainput>Fiji</option> <option value="FI" data-f-datainput>Finland</option> <option value="FR" data-f-datainput>France</option> <option value="GF" data-f-datainput>French Guiana</option> <option value="PF" data-f-datainput>French Polynesia</option> <option value="TF" data-f-datainput>French Southern Terr.</option> <option value="GA" data-f-datainput>Gabon</option> <option value="GM" data-f-datainput>Gambia</option> <option value="GE" data-f-datainput>Georgia</option> <option value="GH" data-f-datainput>Ghana</option> <option value="GI" data-f-datainput>Gibraltar</option> <option value="GR" data-f-datainput>Greece</option> <option value="GL" data-f-datainput>Greenland</option> <option value="GD" data-f-datainput>Grenada</option> <option value="GP" data-f-datainput>Guadeloupe</option> <option value="GU" data-f-datainput>Guam</option> <option value="GT" data-f-datainput>Guatemala</option> <option value="GN" data-f-datainput>Guinea</option> <option value="GW" data-f-datainput>Guinea-Bissau</option> <option value="GY" data-f-datainput>Guyana</option> <option value="HT" data-f-datainput>Haiti</option> <option value="HM" data-f-datainput>Heard/McDonald Isls.</option> <option value="HN" data-f-datainput>Honduras</option> <option value="HK" data-f-datainput>Hong Kong</option> <option value="HU" data-f-datainput>Hungary</option> <option value="IS" data-f-datainput>Iceland</option> <option value="IN" data-f-datainput>India</option> <option value="ID" data-f-datainput>Indonesia</option> <option value="IR" data-f-datainput>Iran</option> <option value="IQ" data-f-datainput>Iraq</option> <option value="IE" data-f-datainput>Ireland</option> <option value="IL" data-f-datainput>Israel</option> <option value="IT" data-f-datainput>Italy</option> <option value="JM" data-f-datainput>Jamaica</option> <option value="JP" data-f-datainput>Japan</option> <option value="JO" data-f-datainput>Jordan</option> <option value="KZ" data-f-datainput>Kazakhstan</option> <option value="KE" data-f-datainput>Kenya</option> <option value="KI" data-f-datainput>Kiribati</option> <option value="KP" data-f-datainput>Korea (North)</option> <option value="KR" data-f-datainput>Korea (South)</option> <option value="KW" data-f-datainput>Kuwait</option> <option value="KG" data-f-datainput>Kyrgyzstan</option> <option value="LA" data-f-datainput>Laos</option> <option value="LV" data-f-datainput>Latvia</option> <option value="LB" data-f-datainput>Lebanon</option> <option value="LS" data-f-datainput>Lesotho</option> <option value="LR" data-f-datainput>Liberia</option> <option value="LY" data-f-datainput>Libya</option> <option value="LI" data-f-datainput>Liechtenstein</option> <option value="LT" data-f-datainput>Lithuania</option> <option value="LU" data-f-datainput>Luxembourg</option> <option value="MO" data-f-datainput>Macau</option> <option value="MK" data-f-datainput>Macedonia</option> <option value="MG" data-f-datainput>Madagascar</option> <option value="MW" data-f-datainput>Malawi</option> <option value="MY" data-f-datainput>Malaysia</option> <option value="MV" data-f-datainput>Maldives</option> <option value="ML" data-f-datainput>Mali</option> <option value="MT" data-f-datainput>Malta</option> <option value="MH" data-f-datainput>Marshall Islands</option> <option value="MQ" data-f-datainput>Martinique</option> <option value="MR" data-f-datainput>Mauritania</option> <option value="MU" data-f-datainput>Mauritius</option> <option value="YT" data-f-datainput>Mayotte</option> <option value="MX" data-f-datainput>Mexico</option> <option value="FM" data-f-datainput>Micronesia</option> <option value="MD" data-f-datainput>Moldova</option> <option value="MC" data-f-datainput>Monaco</option> <option value="MN" data-f-datainput>Mongolia</option> <option value="MS" data-f-datainput>Montserrat</option> <option value="MA" data-f-datainput>Morocco</option> <option value="MZ" data-f-datainput>Mozambique</option> <option value="MM" data-f-datainput>Myanmar</option> <option value="MP" data-f-datainput>N. Mariana Isls.</option> <option value="NA" data-f-datainput>Namibia</option> <option value="NR" data-f-datainput>Nauru</option> <option value="NP" data-f-datainput>Nepal</option> <option value="NL" data-f-datainput>Netherlands</option> <option value="AN" data-f-datainput>Netherlands Antilles</option> <option value="NC" data-f-datainput>New Caledonia</option> <option value="NZ" data-f-datainput>New Zealand</option> <option value="NI" data-f-datainput>Nicaragua</option> <option value="NE" data-f-datainput>Niger</option> <option value="NG" data-f-datainput>Nigeria</option> <option value="NU" data-f-datainput>Niue</option> <option value="NF" data-f-datainput>Norfolk Island</option> <option value="NO" data-f-datainput>Norway</option> <option value="OM" data-f-datainput>Oman</option> <option value="PK" data-f-datainput>Pakistan</option> <option value="PW" data-f-datainput>Palau</option> <option value="PS" data-f-datainput>Palestinian Territory, Occupied</option> <option value="PA" data-f-datainput>Panama</option> <option value="PG" data-f-datainput>Papua New Guinea</option> <option value="PY" data-f-datainput>Paraguay</option> <option value="PE" data-f-datainput>Peru</option> <option value="PH" data-f-datainput>Philippines</option> <option value="PN" data-f-datainput>Pitcairn</option> <option value="PL" data-f-datainput>Poland</option> <option value="PT" data-f-datainput>Portugal</option> <option value="PR" data-f-datainput>Puerto Rico</option> <option value="QA" data-f-datainput>Qatar</option> <option value="RE" data-f-datainput>Reunion</option> <option value="RO" data-f-datainput>Romania</option> <option value="RU" data-f-datainput>Russian Federation</option> <option value="RW" data-f-datainput>Rwanda</option> <option value="KN" data-f-datainput>Saint Kitts and Nevis</option> <option value="LC" data-f-datainput>Saint Lucia</option> <option value="WS" data-f-datainput>Samoa</option> <option value="SM" data-f-datainput>San Marino</option> <option value="ST" data-f-datainput>Sao Tome/Principe</option> <option value="SA" data-f-datainput>Saudi Arabia</option> <option value="SN" data-f-datainput>Senegal</option> <option value="CS" data-f-datainput>Serbia and Montenegro</option> <option value="SC" data-f-datainput>Seychelles</option> <option value="SL" data-f-datainput>Sierra Leone</option> <option value="SG" data-f-datainput>Singapore</option> <option value="SK" data-f-datainput>Slovak Republic</option> <option value="SI" data-f-datainput>Slovenia</option> <option value="SB" data-f-datainput>Solomon Islands</option> <option value="SO" data-f-datainput>Somalia</option> <option value="ZA" data-f-datainput>South Africa</option> <option value="ES" data-f-datainput>Spain</option> <option value="LK" data-f-datainput>Sri Lanka</option> <option value="SH" data-f-datainput>St. Helena</option> <option value="PM" data-f-datainput>St. Pierre and Miquelon</option> <option value="VC" data-f-datainput>St. Vincent and Grenadines</option> <option value="SD" data-f-datainput>Sudan</option> <option value="SR" data-f-datainput>Suriname</option> <option value="SJ" data-f-datainput>Svalbard/Jan Mayen Isls.</option> <option value="SZ" data-f-datainput>Swaziland</option> <option value="SE" data-f-datainput>Sweden</option> <option value="CH" data-f-datainput>Switzerland</option> <option value="SY" data-f-datainput>Syria</option> <option value="TW" data-f-datainput>Taiwan</option> <option value="TJ" data-f-datainput>Tajikistan</option> <option value="TZ" data-f-datainput>Tanzania</option> <option value="TH" data-f-datainput>Thailand</option> <option value="TL" data-f-datainput>Timor-Leste</option> <option value="TG" data-f-datainput>Togo</option> <option value="TK" data-f-datainput>Tokelau</option> <option value="TO" data-f-datainput>Tonga</option> <option value="TT" data-f-datainput>Trinidad and Tobago</option> <option value="TN" data-f-datainput>Tunisia</option> <option value="TR" data-f-datainput>Turkey</option> <option value="TM" data-f-datainput>Turkmenistan</option> <option value="TC" data-f-datainput>Turks/Caicos Isls.</option> <option value="TV" data-f-datainput>Tuvalu</option> <option value="UM" data-f-datainput>US Minor Outlying Is.</option> <option value="UG" data-f-datainput>Uganda</option> <option value="UA" data-f-datainput>Ukraine</option> <option value="AE" data-f-datainput>United Arab Emirates</option> <option value="UY" data-f-datainput>Uruguay</option> <option value="UZ" data-f-datainput>Uzbekistan</option> <option value="VU" data-f-datainput>Vanuatu</option> <option value="VA" data-f-datainput>Vatican City</option> <option value="VE" data-f-datainput>Venezuela</option> <option value="VN" data-f-datainput>Viet Nam</option> <option value="VG" data-f-datainput>Virgin Islands (British)</option> <option value="VI" data-f-datainput>Virgin Islands (U.S.)</option> <option value="EH" data-f-datainput>Western Sahara</option> <option value="YE" data-f-datainput>Yemen</option> <option value="ZM" 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