Buffalo Filter: Product Evaluation

Other Product Evaluation

The following form is for new product evaluations for LapEvac sent through Buffalo Filter’s sampling program. Please take a moment to fill out the sheet below so that we can record your feedback. If you have questions please contact Customer Support at 1-800-343-2324. Thank you!


*Name:
Title:
Facility:
Address:
City:
State:
Zip Code:
Phone:
Ext:
*E-Mail:
What is the name of your representative or Distributor?
Procedure type:
Smoke Evacuation System Used:
SE Method of Activation: Footswitch Remote Switch Constant "On"
Power/Suction Level Used:
Electrosurgical Generator Used:
Electrosurgical Pencil Used:
Buffalo Filter Product Used (part number):
Method of Smoke Evacuation Previously used Evacuation Used: Sterile Remote Switch
Packaging allowed efficient transfer to sterile field: Comments: Electrosurgical Pencil attached easily: Comments: Product attached easily to filter/additional hose: Comments: Noise level of this product is acceptable: Comments: Suction/Smoke capture is adequate: Comments: Overall, this product is convenient to use: Comments: Facility will likely purchase this product in the future: Comments:
Additional comments: