Device User Feedback Questionnaire

Using the form below, physicians are able to rate their experience on the use of Epimed products.
This input is vital to Epimed’s continued success. The questionnaire takes approximately 3-5 minutes.

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Facility Address
Select Product Category

Approximately how many years have you been using the selected Epimed product?
History/Duration of Use
If applicable, do you feel the packaging is acceptable to present to the sterile field?
Packaging
On a scale of 1-10, how likely would you be to recommend this product?
Have you experienced any challenges during use, that in your opinion, were directly attributed to the selected device?
IHR-527 Rev. 2

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