Exit Survey - Perito Urology

Perito Urology Training Exit Survey

Thanks for your recent participation in training with Dr. Paul Perito of Perito Urology. We strive to instruct every attendee to perform the safest and most effective surgical experience and would appreciate your feedback. Kindly provide your answers to the following:

Your Name(Required)

First Last

Your Email Address(Required)

Email Address Confirm Email Address

I feel prepared to place penile implants using a minimally invasive technique. (1-10)(Required)

Please enter a number from 1 to 10.

The surgical technique and instruction provided by Dr. Perito was informative and tailored to my level of expertise. (1-10)(Required)

Please enter a number from 1 to 10.

The surgical and clinical facilities met or exceeded my expectations. (1-10)(Required)

Please enter a number from 1 to 10.

My questions were answered to my satisfaction. (1-10)(Required)

Please enter a number from 1 to 10.

Please provide any additional feedback:

As a medical professional trained in the minimally invasive Perito Implant™ technique, I am willing to display my certification on the website of the practice or institution of my employment and agree to contact the responsible parties to display it accordingly.(Required)