Buffalo Filter: Our Company

Smoke Evacuation Evaluation

The following form is for new product evaluations for smoke evacuators 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!


*Distributor or Representative:
Buffalo Filter® Product(s) Under Evaluation:
Lot # / Serial #:
Facility Name:
Address:
City:
State:
Zip Code:
Contact Name:
Title:
Phone Number:
Extension:
*E-Mail:
Procedures used on:
Accessories used:
Please check answer: 5 = Best \| 3 = Average \| 1 = Not Sufficient Please rate the Smoke Evacuator for ease of Use: 5 \| 4 \| 3 \| 2 \| 1 Comments: How would you rate the noise level of the Smoke Evacuator? 5 \| 4 \| 3 \| 2 \| 1 Comments: Please rate the Smoke Evacuation Accessories used: 5 \| 4 \| 3 \| 2 \| 1 Comments: Would you recommend this Smoke Evacuator for Purchase? Yes \| No Comments: