COOL RENEWAL- Physician Survey

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1. Address

Physician Name

Clinic Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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2. How did you hear about Cool Renewal?

Online Search

Advertisment

Distributor Catalog- Online or Print

Distributor Representative

Tradeshow/ Meeting

Another Cool Renewal Customer

Other (please specify)

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3. How Satisfied are you with the performance of Cool Renewal?

Very Satisfied

Satisfied

Disappointed

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4. What do you think about the price?

Very Affordable

Affordable

Too Expensive

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5. Which Applicators do you prefer to use?

Foam Tipped Applicators

Plastic Isolation Funnels

Skin Tag Tweezers

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6. Which types of skin lesions do you typically treat?

Warts

Plantar Warts

Skin Tags

Age Spots/ Keratosis

Other (please specify)

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7. Have you ever used any other types of Cryosurgery Products?

Liquid Nitrogen

Histofreezer

CryoDose

Verruca-Freeze

CryOmega

CryoProbe

CryoPen

Nitrous Oxide

Other (please specify)

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8. Who is your preferred Medical Supply Distributor?

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9. Do you have any suggestions for improving our product?

Suggestion 1

Suggestion 2

Suggestion 3

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* 1. Address

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* 2. How did you hear about Cool Renewal?

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* 3. How Satisfied are you with the performance of Cool Renewal?

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* 4. What do you think about the price?

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* 5. Which Applicators do you prefer to use?

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* 6. Which types of skin lesions do you typically treat?

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* 7. Have you ever used any other types of Cryosurgery Products?

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* 8. Who is your preferred Medical Supply Distributor?

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* 9. Do you have any suggestions for improving our product?

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* 10. Nothing speaks louder than personal experience. Please provide a brief testimonial about your experience with Cool Renewal!

1. Address

2. How did you hear about Cool Renewal?

3. How Satisfied are you with the performance of Cool Renewal?

4. What do you think about the price?

5. Which Applicators do you prefer to use?

6. Which types of skin lesions do you typically treat?

7. Have you ever used any other types of Cryosurgery Products?

8. Who is your preferred Medical Supply Distributor?

9. Do you have any suggestions for improving our product?

10. Nothing speaks louder than personal experience. Please provide a brief testimonial about your experience with Cool Renewal!