Post Market Clinical Follow-up

Your Full Name: *

Phone Number: *

Email Address: *

Device Name: *

Serial Number: *

Clinic Name: *

Address: *

Have you easily accessed the electronic user manual? *

Would you prefer to have user manual in electronic form or paper form? *

Have you read the user manual thoroughly and carefully? *

Do you know the intended uses of the device? *

Do you use the device for indications other than those mentioned in the user manual? *

In your experience, can you add items to the contraindications written in the user manual? *

Is the information in the user manual and labels sufficient? *

Are the signs and symptoms in the device completely understandable? *

Is there a need for training for using the device? *

How familiar are you with the patient preparation process? *

Is the device set-up and connection to the patient easy? *

Does the patient feel comfortable with the device being placed on his/her limb? *

In general, do you approve of the safety and clinical effects of the device? *

Name the most effective intended uses of the device:

For which of the intended uses do you consider the device ineffective?

Explain if you notice any defects in the operation of the device, both hardware and software:

Is there anything else you would like to mention?

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