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* 1. Representative Name

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* 2. Surgeon Name

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* 3. Date of surgery:

Date

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* 4. Reason for Redirect System utilization, include bone quality of the patient.

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* 5. Location the Redirect System was used:

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* 6. Shaft type used?

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* 7. Rate shaft loading experience.

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* 8. Which wire was used with the Redirect System?

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* 9. Rate your experience introducing the shaft over the guidewire.

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* 10. What size Flexible Drill did you use?

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* 11. Did the Redirect System help you position and maintain the wire in the desired position?

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* 12. Was the Steerable Guide Sleeve Used?

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* 13. Did you use any of the following instruments to maintain wire position when removing the Redirect System? (Choose all that apply)

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* 14. Would you say the redirect system enabled you to complete a case that would otherwise have been difficult or impossible to complete without its availability?

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* 15. Please provide any feedback or suggestions for improvement not captured above.

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