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* 1. Your Name

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* 2. Customer Name

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* 3. Hospital Name

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* 4. Is this hospital affiliated with an IDN?

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* 5. HCP Role

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* 6. What device do they use for Stereo?  Select all that apply.

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* 7. What device do they use for Ultrasound Core Biopsies?  Select all that apply. 

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* 8. What device do they use for Ultrasound VAB?  Select all that apply

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* 9. What device do they use for MRI Guided Biopsies?  Select all that apply

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* 10. What Markers do they use?  Select all that apply

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* 11. What localization device do they use? Select all that apply

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* 12. Would you recommend this HCP for VOC or presenting?

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* 13. What is your goal with this customer/account?

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* 14. Is there anything specific you would like to share with this account?

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