New Product Survey

Submit Product Ideas

Lack the right tool for the job?
Bionix is looking for new problems to solve. Submit your biggest problem and the solution
could be one of next years innovative new products. Already have a solution in mind?
Complete Section II and your idea could become part of the Bionix Product line.

Name:

Title:

Phone:

Fax:

Email:

Section I
1. What is the # 1 procedure based problem you face in your practice?

2. Does the problem affect a variety of medical professionals? YESNO

3. Are there other products that address this problem? YESNO

4. Are there other methods of completing the associated task that minimize this problem? YESNO

5. Do you have a solution to this problem in mind? YESNO If yes, please continue.

Section II

6. Is the solution an improvement to an existing product or procedure? YESNO

7. Is the solution designed for single patient use? YESNO

8. Is the solution to be used by medical professionals? YESNO

Please submit the completed survey online or Fax to 800.455.5678. If you submitted a
problem, check back to see if Bionix was able to create a product solution. If you have
submitted a product idea, a member of our team will contact you to discuss it further.

Thank you for your time and ideas.