1. How many years have you been practicing surgery?   
2. What type of program are you in?   
3. Have you used any surgical simulators before using the cleft lip simulator?     
    If yes, which simulator?     
4. How many cleft lip repair surgeries have you seen or been involved in prior to using the simulator?   
5. Do you think that the cleft simulator helps you understand the basic steps of the procedure better?   
6. Which features of the simulator do you like the best? (Interactivity, Animated Procedure, Integrated Testing, Hide/Show Anatomy, etc...)
    
7. What are the features that you would like to see in future versions? (Please name in the order of importance to you)
    
8. Is the simulator interface intuitive? What improvements would you like to see in the interface?
    
9. Did you find the testing useful? Would you like to see more testing modes such as incision marking mode?
    
10. Do you think virtual reality simulators such as the cleft lip simulator would be beneficial in your training?   
11. Would you recommend that your program purchase a comprehensive simulator suite in this interactive three-dimensional format?   
12. Name the top 5 procedures that you would want to see as a simulator module. (Please name in the order of importance to you).
      Module #1  
      Module #2  
      Module #3  
      Module #4  
      Module #5  
13. What is the name of your institution?   
14. What is the name of your director?   
15. Please enter your email if you would like to learn about future releases (Optional)
     
16. Your Name (Optional):  
17. Additional Comments (Optional):