SURGEON FEEDBACK FORM
Name of Doctor/Surgeon:
Company/Hospital Name
Contact information
Type of Implant used:
Patient Demographics (general age group):
Feedback Questions:
1. Ease of use based on Product Design and Quality.
How would you rate the ease of handling and implantation of the product, comparing to other products currently available in the market
Excellent
Good
Needs Improvemnet
If it needs improvement, kindly suggest here the type of improvement needed:
How satisfied are you with the design and functionality of the implant?
Satisfied
Dissatisfied
If dissatisfied, kindly provide the details about which aspects make you dissatisfy here:
Are there any specific design features that enhance or hinder its use? (Please specify, if possible):
2. Patient Outcomes:
How would you rate the patient outcomes on post-?
Excellent
Good
Poor
Have there been any unexpected complications or issues related to the implant?
Yes
If Yes, kindly describe here:
No
Additional Comments if any:
3. Documentation Support:
How would you rate the quality of the product documentation and instructions?
Excellent
Good
Neutral
Poor
Were the provided resources sufficient for effective use of the product?
Yes
No
(kindly specify what type of resources are missing/ineffective, if No):
4. Manufacturer’s Support:
How satisfied are you with the support provided by the manufacturer or distributor?
Very Satisfied
Satisfied
Neutral
Dissatisfied
5. Suggestions for Improvement
What improvements would you recommend for the implant or associated services?
Please share any additional insights, experiences, or observations:
Consent for Use of Feedback (Optional):
I consent to my feedback being used anonymously for the products used by me.
Date of Feedback Submission.:
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