Thank you in advance for your confidential feedback.

* 1. How many Sorin heater-cooler devices have you purchased? 

* 2. Please list the model name and purchase date (or approximate date) and indicate if purchased new or used. (If purchased more than one unit, please list each with same information.)

* 3. Did you receive the Sorin Group Field Safety Notice (Date June 15, 2015)?

* 4. Are you currently using the disinfection/cleaning protocol recommended by Sorin?  Attachment 1 of the Field Safety Notice.  If yes, when did this start?

* 5. What are you using to fill the instruments?

* 6. Has unsterile water ever been used to fill the instruments?

* 7. What disinfection/cleaning protocol were you using prior to Sorin's Field Safety Notice?  Please describe.