CUSTOMER PORTS 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 Trocar products you have used, please rate your answer to the following:

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
How would you rate the insertion force of the GENICON product?
The ease of which hand instrumentation passes back and forth through our valve systems?
The sealing and instrument compatibility of our valve systems?
The effectiveness of our facial thread systems?
The user friendliness of our CO2 port slide valve system?
Your overall opinion as to the design and function of the GENICON port system?
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100% of survey complete.

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