Sterile Aquasonic 100

Survey

Complete the STERILE AQUASONIC® 100 SURVEY and be automatically entered for a chance to WIN $125

($125 prize will be awarded four times per year)

Winning entries will be selected at random four times per year (quarterly). Winners will be contacted
by a Parker Laboratories representative and information will be verified before prize is awarded.
This offer is void where prohibited.

Your responses to this survey will provide information about your experiences using STERILE AQUASONIC® 100 -
The World Standard of Sterile Ultrasound Gels. Your answers will help us improve upon our product's benefits
as well as eliminate any concerns. Your candor is greatly appreciated. This survey is intended only for specialists
who have experience using STERILE AQUASONIC 100 Ultrasound Gel.

Contact Information *Indicates required field

* Name:
* Specialty:
* Facility:
* Address:
* City:
* Postal Code, State/Province:
* E-mail:
* Telephone:
  (with area code)

Survey Questions

1. For what procedures do you specifically use Sterile Aquasonic 100?

2. How often do you perform each of these procedures per week?

3. Has Sterile Aquasonic 100 met your expectations?

Yes No
Please explain your answer

4. Does the current packaging of Sterile Aquasonic 100 meet your procedural needs?

5. Are there any changes or improvements you would like made to Sterile Aquasonic 100?

6. Please tell us in detail if you ever experienced a problem(s) using Sterile Aquasonic 100.

OPT-OUT I cannot accept financial compensation as a reward for completing this survey. If selected as a winner, I request that Parker Laboratories donate the prize to charity at its discretion.

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