CUSTOMER LAVAGE QUESTIONNAIRE

Please take a moment to complete this questionnaire. Our aim is to understand product performance in your market to improve our products and services.

For each question, please select the option that best describes your opinion. Choose from poor to excellent, or N/A if the question is not relevant to your experiences. Feel free to add any comments for each section or at the end of the questionnaire.

* 1. Completed By or on Behalf Of (Name, Organization, Country or Region, and Contact Email or Phone Number)

* 2. Category of Qualification

* 3. If you answered Surgeon in the previous question, please select a specialty subcategory.

* 4. How were the answers acquired ?

* 5. In comparison to other laparoscopic lavage products you have used, please rate your answer to the following:

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
Your satisfaction level with the length of the tubing
Your satisfaction level with the operation of the suction/irrigation buttons
Your satisfaction level with the GENICON Aquas irrigation fluid flow rate
Your satisfaction level with the GENICON Aquas suction rate

* 6. Do you use a laser fiber through a laparoscopic suction/irrigation device?

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100% of survey complete.

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