SWICKER Product Evaluation and Feedback Form After completing a procedure using the SWICKER Surgical Foam Sponge, please provide your feedback.Physician's Name First Last Hospital Name What type of procedure did you perform? Open Surgical Laparoscopic Minimally Invasive Robotic Other What sizes did you use? (check all that apply) 1.5x3 3x3 5x5 9x9 Digit Mitt What thicknesses did you use? (check all that apply) .125 .25 .50 How many total SWICKER Sponges were used during the procedure? 1 2 3 4 5 More than 5 How would you rate the absorbency of the SWICKER Sponge? Very absorbent Comparable to other products Not absorbent How did you clear fluids from the SWICKER Sponge? (Check all that apply) Wring out in saline Wring out in heparinized saline Suction tip Cell saver Other If you chose "Other" please describe here: How would you rate the ease of use? Very easy to use Comparable to other products Not easy to use Will you use this product again? Yes No Not Sure If you responded "not sure" please explain your answer.Any other comments you would like to share?If you answered yes, who can we contact about placing an order?Name First Last PhoneEmail
