CUSTOMER 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.

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* 2. On Behalf Of

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* 3. Category of Qualification

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* 4. If you answered Surgeon in the previous question, please select a specialty subcategory.

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* 5. How were the answers acquired ?

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* 6. How would you rate the performance of the following products in the Operating Room ?

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
Bladeless Ports ( Natura, GeniLook, GeniPalm)
Shielded Ports ( GeniShield)
Blunt Ports ( Hasson)
Specimen Retrieval Bags (GeniStrong, SimplyStrong, Ezee )
Veress Needle ( GeniFirst)
Ligation ( GeniClip, A Li-Gator)
Monopolar ( GeniSurge, NanoSurge)
Bipolar (BiSurge)
Suction irrigation ( GeniFlow, PowerFlow)

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* 7. How would you rate the packaging of the products ?

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
Shipping Cartons 
Shelf Boxes 
Individual Units
Insert cards

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* 8. How would you rate the support received from your contact with GENICON ?

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
Sales Representatives
Customer Service Reps 
Order Acknowledgements
Delivery Times
General Inquiries ( Pricing, Bids, etc. )

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* 9. How would you rate the following Marketing or Informational materials ?

  Poor Unsatisfactory Indifferent Satisfactory Excellent N/A
Instructions for Use ( e- IFU)
Literature Pieces and Catalog 
Website ( www.geniconendo.com)

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* 10. Have you ever filed a complaint concerning any GENICON products ? 

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* 11. How would you rate the speed at which the complaint was handled ?

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* 12. How would you rate the quality of the response and solution to the complain?

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* 13. File Upload

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