Acu-Loc 3 LMR Case Report

Please fill out after EACH CASE
LMR AL3 Case

Surgeon / Facility Information

Surgeon Name
Surgeon Name
First Name
Last Name

What implants were used during the procedure? Check all that apply.
0 - Poorly
10 - Very well
0 - Poorly
10 - Very well
0 - Not confident
10 - Very confident
0 - Poorly
10 - Extremely well
0 - Poorly
10 - Very well
0 - Difficult
10 - Very easy
0 - Not satisfied
10 - Very satisfied
Were any of the following specialty instruments used during this case? Check all that apply.
0 - Poorly
10 - Very well
0 - Poorly
10 - Very well
0 - Poorl
10 - Very well
0 - Not satisfied
10 - Very satisfied
0 - Not satisfied
10 - Very satisfied
0 - Difficult
10 - Very easy