CUSTOMER PEDIATRIC 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 to the previous question, please select a specialty subcategory.

* 4. How were the answers acquired ?

* 5. Please rate the performance of GENICON's 3mm products

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
Satisfaction with the fixation system on the cannula
Satisfaction with instrument exchanges with Genicon 3mm cannula
4. Satisfaction with instrument exchanges with Genicon 3mm cannula with CO2 port

* 6. Do you see a need for additional 3mm cannula lengths?

* 7. Would you use a 3mm suction/irrigation probe?

* 8. What would be a good volume for the pediatric specific retrieval bag in a 5mm working diameter?

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100% of survey complete.

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