Thanks for being willing to help me. Please complete the form as best you can.

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  1. What is your name?

     
  2. Who told you about my project?

     
  3. What are your job responsibilities?

     
  4. Does anything in your workplace seem especially inefficient? (i.e. a certain tool requires a lot of setup, a particular process takes especially long, or a certain product generates a lot of waste material.)

     
  5. What sort of risks impede your work? (i.e. risk of losing rags during surgery or risk of giving wrong dosage)

     
  6. Do any tools or devices seem to cost more than they should? (i.e. syringes, leg braces, etc)

     
  7. Are there any particular tools or devices you wish you had?

     
  8. What is the most frustrating part of your job?

     
  9. Is there anything else you can tell me that may be beneficial to my project?