Advanced Wound Care Evaluation Form

PURPOSE: HALYARD* Advanced Wound Care dressings are designed to provide an optimal wound healing environment. The portfolio offers a range of products indicated for low to high levels of wound exudate, various sizes, and primary or secondary dressing options.

"*" indicates required fields

Name

This field is for validation purposes and should be left unchanged.

Evaluator Name (Nurse or other clinician)

First Last

Facility Name:*

Which product are you evaluating?*

Criteria To Be Rated:

Evaluation Period

HALYARD* dressing used as:*

Primary dressing

Secondary dressing

How did HALYARD* dressing(s) function compared to current products in use at your facility?*

Better

Same

Worse

Please share any additional feedback from your experience during this product trial

	Excellent	Very Good	Good	Fair	Poor
Ease of Application
Ease of Removal
Effectiveness of Adhesive
Exudate Absorption
Conformability
Wear Time
Patient Comfort
Appearance of Surrounding Skin
Overall Performance