www.tfaforms.com
Open in
urlscan Pro
3.229.194.125
Public Scan
URL:
https://www.tfaforms.com/412383
Submission: On December 12 via api from US — Scanned from DE
Submission: On December 12 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST https://www.tfaforms.com/api_v2/workflow/processor
<form method="post" action="https://www.tfaforms.com/api_v2/workflow/processor" class="hintsTooltip labelsLeftAligned" id="412383" role="form">
<div class="saveAndResume">
<div class="oneField">
<span class="oneChoice"><input type="checkbox" id="tfa_saveForLater" name="tfa_saveForLater" value="1" data-conditionals="#saveAndResumeFieldset" autocomplete="off"><label for="tfa_saveForLater" class="postField">Save my progress and resume
later</label></span> |
<a href="https://www.tfaforms.com/forms/resume/412383" onclick="return confirm('Are you sure you want to resume a previous response? Any information you just entered on this page will be discarded.');">Resume a previously saved form</a>
</div>
</div>
<div class="saveAndResume offstate" id="saveAndResumeFieldset" data-condition="`#tfa_saveForLater`">
<fieldset>
<legend>Resume Later</legend>
<p class="instructions">In order to be able to resume this form later, please enter your email and choose a password.</p>
<div class="oneField">
<label class="preField" for="tfa_resumeEmail">Your Email:</label><input type="text" value="" name="tfa_resumeEmail" id="tfa_resumeEmail" disabled="">
</div>
<div class="oneField">
<label class="preField" for="tfa_resumePassword">A Password:</label><input type="password" value="" name="tfa_resumePassword" id="tfa_resumePassword" disabled="">
</div>
<div class="oneField">
<label class="preField" for="tfa_confirmPassword">Confirm Password:</label><input type="password" value="" name="tfa_confirmPassword" id="tfa_confirmPassword" disabled="">
</div>
<div class="actions">
<script type="text/javascript">
wFORMS.behaviors.validation.passwordStrength = "medium";
</script><input type="button" class="primaryAction" id="tfa_resumeLater" name="tfa_resumeLater" value="Save" disabled="">
</div>
</fieldset>
</div>
<div class="htmlSection" id="tfa_2334461304275">
<div class="htmlContent" id="tfa_2334461304275-HTML">
<div style="text-align: center;"><img style="word-spacing: normal;" alt="ION2" src="//www.tfaforms.com/forms/get_image/91532/v1Thd6wdSxqSZN97NzGX91vYP8C4YrL5ojeaBAix4ymQeT3KM4QYkIG25IGrf0YI-ION.JPG"></div>
</div>
</div>
<fieldset id="tfa_2334461303762" class="section inline">
<div class="htmlSection" id="tfa_2334461303767">
<div class="htmlContent" id="tfa_2334461303767-HTML">
<p class="MsoNormal"></p><span style="font-size:8.0pt;line-height:107%;font-family:"Calibri",sans-serif;
mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:"Times New Roman";
mso-bidi-theme-font:minor-bidi;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">
<p class="MsoNormal"><span style="font-size:10.0pt;line-height:107%">The information provided in this site survey will be used by Intuitive Surgical Field Engineers to properly configure the ION system to the hospital network for the
purposes of uploading service logs to Intuitive OnSite Server. <a href="https://www.intuitive.com/en-us/products-and-services/ion?gclid=Cj0KCQiA0-6ABhDMARIsAFVdQv8mW1OpIk3xg6mq4UEunjgWhU6W7I-J1bHERLIb3WQptvHm7QBJI4kaAm59EALw_wcB">Click
here to get more information on the ION system.</a> </span></p>
<p class="MsoNormal"><span style="font-size:10.0pt;line-height:107%"> </span></p>
<span style="font-size: 10pt; background-color: transparent; word-spacing: normal;">If you have any questions you can call our <b>Product Networking Technical Support Staff</b> at <b>1
866 225-2071</b> </span>
</span><span style="font-weight: 700; font-size: 13.6px; text-align: center;"><span style="font-size: 10pt; line-height: 14.552px;">or email PND@</span></span><span
style="font-size: 10pt; text-align: center; line-height: 14.552px;"><a href="mailto:pnd@intusurg.com" style="text-decoration-line: underline; outline: 0px;"><span style="font-weight: 700;">intusurg.com</span></a><span
style="font-weight: 700;">.</span></span>
</div>
</div>
</fieldset>
<fieldset id="tfa_2334461303727" class="section highlighted">
<div class="oneField field-container-D " id="tfa_2334461303832-D">
<label id="tfa_2334461303832-L" class="label preField reqMark" for="tfa_2334461303832">Hospital Name</label>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2334461303832" name="tfa_2334461303832" value="" title="Hospital Name" class="required"></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303834-D">
<label id="tfa_2334461303834-L" class="label preField " for="tfa_2334461303834">Address</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461303834" name="tfa_2334461303834" value="" title="Address" class=""></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303723-D">
<label id="tfa_2334461303723-L" class="label preField " for="tfa_2334461303723">City</label>
<div class="inputWrapper"><textarea id="tfa_2334461303723" name="tfa_2334461303723" title="City" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303724-D">
<label id="tfa_2334461303724-L" class="label preField " for="tfa_2334461303724">State</label>
<div class="inputWrapper"><textarea id="tfa_2334461303724" name="tfa_2334461303724" title="State" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303726-D">
<label id="tfa_2334461303726-L" class="label preField reqMark" for="tfa_2334461303726">Zip Code</label>
<div class="inputWrapper"><textarea aria-required="true" id="tfa_2334461303726" name="tfa_2334461303726" title="Zip Code" class="required"></textarea></div>
</div>
</fieldset>
<fieldset id="tfa_2334461303729" class="section inline highlighted">
<div class="oneField field-container-D " id="tfa_2334461303725-D">
<label id="tfa_2334461303725-L" class="label preField reqMark" for="tfa_2334461303725">Customer Contact</label>
<div class="inputWrapper"><textarea aria-required="true" id="tfa_2334461303725" name="tfa_2334461303725" title="Customer Contact" class="required"></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303728-D">
<label id="tfa_2334461303728-L" class="label preField " for="tfa_2334461303728">Title</label>
<div class="inputWrapper"><textarea id="tfa_2334461303728" name="tfa_2334461303728" title="Title" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_PhoneNumber-D">
<label id="tfa_PhoneNumber-L" class="label preField reqMark" for="tfa_PhoneNumber">Phone Number</label>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_PhoneNumber" name="tfa_PhoneNumber" value="" title="Phone Number" class="validate-phone required"></div>
</div>
<div class="oneField field-container-D " id="tfa_ContactAtHospita-D">
<label id="tfa_ContactAtHospita-L" class="label preField reqMark" for="tfa_ContactAtHospita">Email</label>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_ContactAtHospita" name="tfa_ContactAtHospita" value="" title="Email" class="required"></div>
</div>
</fieldset>
<fieldset id="tfa_2334461303745" class="section inline highlighted">
<fieldset id="tfa_2334461303754" class="section inline highlighted">
<div class="oneField field-container-D " id="tfa_2334461303755-D">
<label id="tfa_2334461303755-L" class="label preField reqMark" for="tfa_2334461303755">IT Primary Contact Name</label>
<div class="inputWrapper"><textarea aria-required="true" id="tfa_2334461303755" name="tfa_2334461303755" title="IT Primary Contact Name" class="required"></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303756-D">
<label id="tfa_2334461303756-L" class="label preField reqMark" for="tfa_2334461303756">Phone Number</label>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2334461303756" name="tfa_2334461303756" value="" title="Phone Number" class="validate-phone required"></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303757-D">
<label id="tfa_2334461303757-L" class="label preField reqMark" for="tfa_2334461303757">Email</label>
<div class="inputWrapper"><input aria-required="true" type="text" id="tfa_2334461303757" name="tfa_2334461303757" value="" title="Email" class="required"></div>
</div>
</fieldset>
</fieldset>
<fieldset id="tfa_2334461303766" class="section highlighted">
<div class="htmlSection" id="tfa_2334461303769">
<div class="htmlContent" id="tfa_2334461303769-HTML">
<p class="MsoNormal"></p><span style="font-size:8.0pt;line-height:107%;font-family:"Calibri",sans-serif;
mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:"Times New Roman";
mso-bidi-theme-font:minor-bidi;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">
<p class="MsoNormal"></p><span style="font-size: 10pt; line-height: 107%;">The ION endoluminal system consists of 2 components: the ION system cart and the PlanPoint laptop, each device requires a private IP. The Planpoint and the ION
require access to OnSite URLs. While the Planpoint and ION system cart are networked they do not communicate with each other; there are no network interconnectivity requirements between the 2 devices.</span>
</span>
</div>
</div>
<div class="htmlSection" id="tfa_2334461304023">
<div class="htmlContent" id="tfa_2334461304023-HTML">
<p class="MsoNormal"></p><span style="font-size:8.0pt;line-height:107%;font-family:"Calibri",sans-serif;
mso-ascii-theme-font:minor-latin;mso-fareast-font-family:Calibri;mso-fareast-theme-font:
minor-latin;mso-hansi-theme-font:minor-latin;mso-bidi-font-family:"Times New Roman";
mso-bidi-theme-font:minor-bidi;mso-ansi-language:EN-US;mso-fareast-language:
EN-US;mso-bidi-language:AR-SA">
<p class="MsoNormal"></p><span style="font-size: 10pt; line-height: 107%;">
<p class="MsoNormal" style="text-align: center;"><b><span style="font-size:10.0pt;line-height:107%">Required
Internet Access</span></b></p>
<p class="MsoNormal"><b><span style="font-size:8.0pt;line-height:107%"> </span></b></p>
<p class="MsoNormal"><b><span style="font-size:8.0pt;line-height:107%;color:red">OnSite
for the ION system and PlanPoint requires access via an outbound TCP/IP port
443 communication to:</span></b></p>
<p class="MsoNormal"><b><span style="font-size:8.0pt;line-height:107%;color:red"><br></span></b></p>
<p class="MsoNormal"><b><span style="font-size:8.0pt;line-height:107%;color:red">PlanPoint Laptop</span></b></p>
<p class="MsoListParagraphCxSpFirst" style="text-indent:-.25in;mso-list:l0 level1 lfo1"><span style="font-size:8.0pt;line-height:107%;font-family:Symbol;mso-fareast-font-family:
Symbol;mso-bidi-font-family:Symbol;color:red;mso-bidi-font-weight:bold">·<span
style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: "Times New Roman";"> </span></span><b><span style="font-size:8.0pt;line-height:
107%;color:red">ionps.davinci-onsite.com 199.87.79.194</span></b></p>
<p class="MsoListParagraphCxSpFirst" style="text-indent:-.25in;mso-list:l0 level1 lfo1"><b><span style="font-size:8.0pt;line-height:
107%;color:red"><br></span></b></p>
<p class="MsoListParagraphCxSpLast" style="text-indent:-.25in;mso-list:l0 level1 lfo1"><span style="font-size:8.0pt;line-height:107%;font-family:Symbol;mso-fareast-font-family:
Symbol;mso-bidi-font-family:Symbol;color:red;mso-bidi-font-weight:bold">·<span
style="font-variant-numeric: normal; font-variant-east-asian: normal; font-stretch: normal; font-size: 7pt; line-height: normal; font-family: "Times New Roman";">
<b>ION System Cart</b></span></span></p>
<p class="MsoListParagraphCxSpLast" style="text-indent:-.25in;mso-list:l0 level1 lfo1"><b><span style="font-size:8.0pt;line-height:
107%;color:red">ion davinci-onsite.com 199.87.79.193</span></b></p>
<p class="MsoNormal"><span style="font-size:8.0pt;line-height:107%"> </span></p>
<span style="font-size: 8pt; word-spacing: normal;">Intuitive does not require any inbound access.</span><span style="font-size: 8pt; word-spacing: normal;"> </span><span style="font-size: 8pt; word-spacing: normal;">OnSite enables
log uploads; timely access to these device logs enhances Intuitive’s ability to service the ION solution.</span><span style="font-size: 8pt; word-spacing: normal;"> </span><span style="font-size: 8pt; word-spacing: normal;">Device
logs do not contain any patient information.</span>.<br><br>
<table class="MsoTableGrid" border="1" cellspacing="0" cellpadding="0" style="border: none;">
<tbody>
<tr>
<td width="312" valign="top" style="width: 233.75pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><b><span style="font-size:10.0pt">Web Proxy</span></b></p>
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><b><span style="font-size:8.0pt"> </span></b></p>
</td>
<td width="312" valign="top" style="width: 233.75pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt"> </span></p>
</td>
</tr>
<tr>
<td width="623" colspan="2" valign="top" style="width: 467.5pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt">ION system or Planpoint does not support a web (https) proxy; neither device has a web browser nor allows a user to navigate a
network.</span></p>
</td>
</tr>
<tr>
<td width="312" valign="top" style="width: 233.75pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt"> </span></p>
</td>
<td width="312" valign="top" style="width: 233.75pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt"> </span></p>
</td>
</tr>
<tr>
<td width="312" valign="top" style="width: 233.75pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt">If a bypass is required, please provide expected date to implement</span></p>
</td>
<td width="312" valign="top" style="width: 233.75pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt">Date:</span></p>
</td>
</tr>
<tr>
<td width="623" colspan="2" valign="top" style="width: 467.5pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt"> </span></p>
</td>
</tr>
<tr>
<td width="623" colspan="2" valign="top" style="width: 467.5pt; padding: 0in 5.4pt;">
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><b><span style="font-size:10.0pt">TLS Packet Inspection Proxy</span></b></p>
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><b><span style="font-size:10.0pt"> </span></b></p>
<p class="MsoNormal" style="margin-bottom:0in;line-height:normal"><span style="font-size:8.0pt">The ION system and Planning Laptop utilizes an Intuitive private PKI certificate to authenticate to OnSite’s server. If deep
packet inspection technologies are used, these are known to break the TLS communication and require a bypass exception. </span></p>
</td>
</tr>
</tbody>
</table>
</span>
</span>
</div>
</div>
</fieldset>
<fieldset id="tfa_2334461304196" class="section highlighted">
<div class="oneField field-container-D " id="tfa_2334461304195-D">
<label id="tfa_2334461304195-L" class="label preField " for="tfa_2334461304195"><b>System Number</b> <i>(ENxxxx)</i></label>
<div class="inputWrapper"><textarea id="tfa_2334461304195" name="tfa_2334461304195" title="System Number (ENxxxx)" class=""></textarea></div>
</div>
</fieldset>
<fieldset id="tfa_2334461304113" class="section highlighted">
<legend id="tfa_2334461304113-L"><b><u>Wired Connections</u></b></legend>
<div class="htmlSection" id="tfa_2334461303770">
<div class="htmlContent" id="tfa_2334461303770-HTML">
<h4 style="text-align: center;">ION System</h4>
<div style="text-align: center;"><i><b>Wired Network Connection</b></i></div>
</div>
</div>
<table class="matrixLayout ">
<thead>
<tr class="headerRow" id="tfa_2334461304108-MTRX">
<th></th>
<th scope="col">Reserved DHCP</th>
<th scope="col">Static</th>
<th scope="col">Intuitive to provide MAC address for interface.</th>
</tr>
</thead>
<tbody>
<tr id="tfa_2334461304108" class="oneField alternate-0 " role="group" aria-labelledby="tfa_2334461304108-L" data-tfa-labelledby="-L tfa_2334461304108-L">
<th scope="row" class="headerCol"><label id="tfa_2334461304108-L" for="tfa_2334461304108" class="label ">Please specify how the IP address will be provided to the ION system (DHCP or Static)? </label></th>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304304" class="" id="tfa_2334461304304" name="tfa_2334461304304" title="Reserved DHCP"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304109" class="" id="tfa_2334461304109" name="tfa_2334461304109" title="Static"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304305" class="" id="tfa_2334461304305" name="tfa_2334461304305" title="Intuitive to provide MAC address for interface."></span></td>
</tr>
</tbody>
</table>
<fieldset id="tfa_2334461304251" class="section column highlighted">
<legend id="tfa_2334461304251-L"><b>ION</b></legend>
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304252-D">
<label id="tfa_2334461304252-L" class="label preField " for="tfa_2334461304252">IP Address</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304252" name="tfa_2334461304252" value="" title="IP Address" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304253-D">
<label id="tfa_2334461304253-L" class="label preField " for="tfa_2334461304253">Subnet Mask</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304253" name="tfa_2334461304253" value="" title="Subnet Mask" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304254-D">
<label id="tfa_2334461304254-L" class="label preField " for="tfa_2334461304254">Gateway</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304254" name="tfa_2334461304254" value="" title="Gateway" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461304301" class="section column highlighted">
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304302-D">
<label id="tfa_2334461304302-L" class="label preField " for="tfa_2334461304302">Primary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304302" name="tfa_2334461304302" value="" title="Primary DNS Server" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304303-D">
<label id="tfa_2334461304303-L" class="label preField " for="tfa_2334461304303">Secondary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304303" name="tfa_2334461304303" value="" title="Secondary DNS Server" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461304017" class="section inline highlighted">
<legend id="tfa_2334461304017-L"><b>Data Jack Location</b></legend>
<div class="oneField field-container-D " id="tfa_2334461304018-D">
<label id="tfa_2334461304018-L" class="label preField " for="tfa_2334461304018">Data Port</label>
<div class="inputWrapper"><textarea id="tfa_2334461304018" name="tfa_2334461304018" title="Data Port" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461304019-D">
<label id="tfa_2334461304019-L" class="label preField " for="tfa_2334461304019">Jack #</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304019" name="tfa_2334461304019" value="" title="Jack #" class=""></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461304020-D">
<label id="tfa_2334461304020-L" class="label preField " for="tfa_2334461304020">Data Port</label>
<div class="inputWrapper"><textarea id="tfa_2334461304020" name="tfa_2334461304020" title="Data Port" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461304021-D">
<label id="tfa_2334461304021-L" class="label preField " for="tfa_2334461304021">Jack #</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304021" name="tfa_2334461304021" value="" title="Jack #" class=""></div>
</div>
</fieldset>
<div class="htmlSection" id="tfa_2334461303818">
<div class="htmlContent" id="tfa_2334461303818-HTML">
<h4 style="text-align: center;">Planpoint Laptop</h4>
<div style="text-align: center;"><i><b>Wired Network Connection</b></i></div>
</div>
</div>
<table class="matrixLayout ">
<thead>
<tr class="headerRow" id="tfa_2334461304151-MTRX">
<th></th>
<th scope="col">Static</th>
<th scope="col">Reserved DHCP</th>
<th scope="col">Intuitive to provide MAC address for interface.</th>
</tr>
</thead>
<tbody>
<tr id="tfa_2334461304151" class="oneField alternate-1 " role="group" aria-labelledby="tfa_2334461304151-L" data-tfa-labelledby="-L tfa_2334461304151-L">
<th scope="row" class="headerCol"><label id="tfa_2334461304151-L" for="tfa_2334461304151" class="label ">Please specify how the IP address will be provided to the Planpoint system (DHCP or Static)? </label></th>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304152" class="" id="tfa_2334461304152" name="tfa_2334461304152" title="Static"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304306" class="" id="tfa_2334461304306" name="tfa_2334461304306" title="Reserved DHCP"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304307" class="" id="tfa_2334461304307" name="tfa_2334461304307" title="Intuitive to provide MAC address for interface."></span></td>
</tr>
</tbody>
</table>
<fieldset id="tfa_2334461304142" class="section column highlighted">
<legend id="tfa_2334461304142-L"><b>Planpoint</b></legend>
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304143-D">
<label id="tfa_2334461304143-L" class="label preField " for="tfa_2334461304143">IP Address</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304143" name="tfa_2334461304143" value="" title="IP Address" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304144-D">
<label id="tfa_2334461304144-L" class="label preField " for="tfa_2334461304144">Subnet Mask</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304144" name="tfa_2334461304144" value="" title="Subnet Mask" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304145-D">
<label id="tfa_2334461304145-L" class="label preField " for="tfa_2334461304145">Gateway</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304145" name="tfa_2334461304145" value="" title="Gateway" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461304280" class="section column highlighted">
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304281-D">
<label id="tfa_2334461304281-L" class="label preField " for="tfa_2334461304281">Primary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304281" name="tfa_2334461304281" value="" title="Primary DNS Server" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304282-D">
<label id="tfa_2334461304282-L" class="label preField " for="tfa_2334461304282">Secondary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304282" name="tfa_2334461304282" value="" title="Secondary DNS Server" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461303865" class="section inline highlighted">
<legend id="tfa_2334461303865-L"><b>Data Jack Location</b></legend>
<div class="oneField field-container-D " id="tfa_2334461303866-D">
<label id="tfa_2334461303866-L" class="label preField " for="tfa_2334461303866">Data Port</label>
<div class="inputWrapper"><textarea id="tfa_2334461303866" name="tfa_2334461303866" title="Data Port" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303869-D">
<label id="tfa_2334461303869-L" class="label preField " for="tfa_2334461303869">Jack #</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461303869" name="tfa_2334461303869" value="" title="Jack #" class=""></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303871-D">
<label id="tfa_2334461303871-L" class="label preField " for="tfa_2334461303871">Data Port</label>
<div class="inputWrapper"><textarea id="tfa_2334461303871" name="tfa_2334461303871" title="Data Port" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303873-D">
<label id="tfa_2334461303873-L" class="label preField " for="tfa_2334461303873">Jack #</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461303873" name="tfa_2334461303873" value="" title="Jack #" class=""></div>
</div>
</fieldset>
</fieldset>
<fieldset id="tfa_2334461304175" class="section highlighted">
<legend id="tfa_2334461304175-L"><b><u>Wireless Connections</u></b></legend>
<div class="htmlSection" id="tfa_2334461303816">
<div class="htmlContent" id="tfa_2334461303816-HTML">
<h4 style="text-align: center;">ION System</h4>
<div style="text-align: center;"><i><b>Wireless Network Connection</b></i></div>
</div>
</div>
<fieldset id="tfa_2334461304318" class="section column highlighted">
<legend id="tfa_2334461304318-L"><b>SSID</b></legend>
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304319-D">
<div class="inputWrapper"><input type="text" id="tfa_2334461304319" name="tfa_2334461304319" value="" title="" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<table class="matrixLayout ">
<thead>
<tr class="headerRow" id="tfa_2334461304227-MTRX">
<th></th>
<th scope="col">Static</th>
<th scope="col">Reserved DHCP</th>
<th scope="col">Intuitive to provide MAC address for interface.</th>
</tr>
</thead>
<tbody>
<tr id="tfa_2334461304227" class="oneField alternate-0 " role="group" aria-labelledby="tfa_2334461304227-L" data-tfa-labelledby="-L tfa_2334461304227-L">
<th scope="row" class="headerCol"><label id="tfa_2334461304227-L" for="tfa_2334461304227" class="label ">Please specify how the IP address will be provided to the ION system (DHCP or Static)? </label></th>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304228" class="" id="tfa_2334461304228" name="tfa_2334461304228" title="Static"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304308" class="" id="tfa_2334461304308" name="tfa_2334461304308" title="Reserved DHCP"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304309" class="" id="tfa_2334461304309" name="tfa_2334461304309" title="Intuitive to provide MAC address for interface."></span></td>
</tr>
</tbody>
</table>
<fieldset id="tfa_2334461304236" class="section column highlighted">
<legend id="tfa_2334461304236-L"><b>ION</b></legend>
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304313-D">
<label id="tfa_2334461304313-L" class="label preField " for="tfa_2334461304313">IP Address</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304313" name="tfa_2334461304313" value="" title="IP Address" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304238-D">
<label id="tfa_2334461304238-L" class="label preField " for="tfa_2334461304238">Subnet Mask</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304238" name="tfa_2334461304238" value="" title="Subnet Mask" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304239-D">
<label id="tfa_2334461304239-L" class="label preField " for="tfa_2334461304239">Gateway</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304239" name="tfa_2334461304239" value="" title="Gateway" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461304287" class="section column highlighted">
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304288-D">
<label id="tfa_2334461304288-L" class="label preField " for="tfa_2334461304288">Primary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304288" name="tfa_2334461304288" value="" title="Primary DNS Server" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304289-D">
<label id="tfa_2334461304289-L" class="label preField " for="tfa_2334461304289">Secondary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304289" name="tfa_2334461304289" value="" title="Secondary DNS Server" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461304210" class="section highlighted">
<legend id="tfa_2334461304210-L"><b>WPA2</b></legend>
<div class="oneField field-container-D " id="tfa_2334461304211-D" role="group" aria-labelledby="tfa_2334461304211-L" data-tfa-labelledby="-L tfa_2334461304211-L">
<label id="tfa_2334461304211-L" class="label preField ">WPA2 </label>
<div class="inputWrapper"><span id="tfa_2334461304211" class="choices vertical "><span class="oneChoice"><input type="checkbox" value="tfa_2334461304212" class="" id="tfa_2334461304212" name="tfa_2334461304212"
aria-labelledby="tfa_2334461304212-L" data-tfa-labelledby="tfa_2334461304211-L tfa_2334461304212-L"><label class="label postField" id="tfa_2334461304212-L" for="tfa_2334461304212"><span
class="input-checkbox-faux"></span>WPA2</label></span></span></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461304213-D" role="group" aria-labelledby="tfa_2334461304213-L" data-tfa-labelledby="-L tfa_2334461304213-L">
<label id="tfa_2334461304213-L" class="label preField ">Autentication</label>
<div class="inputWrapper"><span id="tfa_2334461304213" class="choices vertical "><span class="oneChoice"><input type="checkbox" value="tfa_2334461304214" class="" id="tfa_2334461304214" name="tfa_2334461304214"
aria-labelledby="tfa_2334461304214-L" data-tfa-labelledby="tfa_2334461304213-L tfa_2334461304214-L"><label class="label postField" id="tfa_2334461304214-L" for="tfa_2334461304214"><span
class="input-checkbox-faux"></span>PSK</label></span><span class="oneChoice"><input type="checkbox" value="tfa_2334461304215" class="" id="tfa_2334461304215" name="tfa_2334461304215" aria-labelledby="tfa_2334461304215-L"
data-tfa-labelledby="tfa_2334461304213-L tfa_2334461304215-L"><label class="label postField" id="tfa_2334461304215-L" for="tfa_2334461304215"><span class="input-checkbox-faux"></span>AES/TKIP</label></span><span
class="oneChoice"><input type="checkbox" value="tfa_2334461304216" class="" id="tfa_2334461304216" name="tfa_2334461304216" aria-labelledby="tfa_2334461304216-L" data-tfa-labelledby="tfa_2334461304213-L tfa_2334461304216-L"><label
class="label postField" id="tfa_2334461304216-L" for="tfa_2334461304216"><span class="input-checkbox-faux"></span>EAP-PEAP</label></span></span></div>
</div>
<div class="htmlSection" id="tfa_2334461304217">
<div class="htmlContent" id="tfa_2334461304217-HTML">
<p class="MsoNormal"><span style="font-size:8.0pt;line-height:107%">Note: EAP-TLS digital certificate authentication is not supported</span></p>
</div>
</div>
<div id="tfa_2334461304218" class="section inline group">
<div class="oneField field-container-D " id="tfa_2334461304219-D">
<label id="tfa_2334461304219-L" class="label preField " for="tfa_2334461304219">PSK Key</label>
<div class="inputWrapper"><textarea id="tfa_2334461304219" name="tfa_2334461304219" title="PSK Key" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461304220-D">
<label id="tfa_2334461304220-L" class="label preField " for="tfa_2334461304220">User Name</label>
<div class="inputWrapper"><textarea id="tfa_2334461304220" name="tfa_2334461304220" title="User Name" class=""></textarea></div>
</div>
</div>
<div class="oneField field-container-D " id="tfa_2334461304221-D">
<label id="tfa_2334461304221-L" class="label preField " for="tfa_2334461304221">Password</label>
<div class="inputWrapper"><textarea id="tfa_2334461304221" name="tfa_2334461304221" title="Password" class=""></textarea></div>
</div>
</fieldset>
<div class="htmlSection" id="tfa_2334461303848">
<div class="htmlContent" id="tfa_2334461303848-HTML">
<h4 style="text-align: center;">Planpoint Laptop</h4>
<div style="text-align: center;"><i><b>Wireless Network Connection</b></i></div>
</div>
</div>
<fieldset id="tfa_2334461304322" class="section column highlighted">
<legend id="tfa_2334461304322-L"><b>SSID</b></legend>
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304323-D">
<div class="inputWrapper"><input type="text" id="tfa_2334461304323" name="tfa_2334461304323" value="" title="" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<table class="matrixLayout ">
<thead>
<tr class="headerRow" id="tfa_2334461304185-MTRX">
<th></th>
<th scope="col">Static</th>
<th scope="col">Reserved DHCP</th>
<th scope="col">Intuitive to provide MAC address for interface.</th>
</tr>
</thead>
<tbody>
<tr id="tfa_2334461304185" class="oneField alternate-1 " role="group" aria-labelledby="tfa_2334461304185-L" data-tfa-labelledby="-L tfa_2334461304185-L">
<th scope="row" class="headerCol"><label id="tfa_2334461304185-L" for="tfa_2334461304185" class="label ">Please specify how the IP address will be provided to the Planpoint system (DHCP or Static)? </label></th>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304186" class="" id="tfa_2334461304186" name="tfa_2334461304186" title="Static"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304310" class="" id="tfa_2334461304310" name="tfa_2334461304310" title="Reserved DHCP"></span></td>
<td><span class="oneChoice"><input type="checkbox" value="tfa_2334461304311" class="" id="tfa_2334461304311" name="tfa_2334461304311" title="Intuitive to provide MAC address for interface."></span></td>
</tr>
</tbody>
</table>
<fieldset id="tfa_2334461304190" class="section column highlighted">
<legend id="tfa_2334461304190-L"><b>Planpoint</b></legend>
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304191-D">
<label id="tfa_2334461304191-L" class="label preField " for="tfa_2334461304191">IP Address</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304191" name="tfa_2334461304191" value="" title="IP Address" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304192-D">
<label id="tfa_2334461304192-L" class="label preField " for="tfa_2334461304192">Subnet Mask</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304192" name="tfa_2334461304192" value="" title="Subnet Mask" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304193-D">
<label id="tfa_2334461304193-L" class="label preField " for="tfa_2334461304193">Gateway</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304193" name="tfa_2334461304193" value="" title="Gateway" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461304294" class="section column highlighted">
<table class="columnLayout">
<tbody>
<tr>
<td>
<div class="oneField field-container-D " id="tfa_2334461304295-D">
<label id="tfa_2334461304295-L" class="label preField " for="tfa_2334461304295">Primary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304295" name="tfa_2334461304295" value="" title="Primary DNS Server" class=""></div>
</div>
</td>
<td>
<div class="oneField field-container-D " id="tfa_2334461304296-D">
<label id="tfa_2334461304296-L" class="label preField " for="tfa_2334461304296">Secondary DNS Server</label>
<div class="inputWrapper"><input type="text" id="tfa_2334461304296" name="tfa_2334461304296" value="" title="Secondary DNS Server" class=""></div>
</div>
</td>
</tr>
</tbody>
</table>
</fieldset>
<fieldset id="tfa_2334461303893" class="section highlighted">
<legend id="tfa_2334461303893-L"><b>WPA2</b></legend>
<div class="oneField field-container-D " id="tfa_2334461303894-D" role="group" aria-labelledby="tfa_2334461303894-L" data-tfa-labelledby="-L tfa_2334461303894-L">
<label id="tfa_2334461303894-L" class="label preField ">WPA2 </label>
<div class="inputWrapper"><span id="tfa_2334461303894" class="choices vertical "><span class="oneChoice"><input type="checkbox" value="tfa_2334461303895" class="" id="tfa_2334461303895" name="tfa_2334461303895"
aria-labelledby="tfa_2334461303895-L" data-tfa-labelledby="tfa_2334461303894-L tfa_2334461303895-L"><label class="label postField" id="tfa_2334461303895-L" for="tfa_2334461303895"><span
class="input-checkbox-faux"></span>WPA2</label></span></span></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303896-D" role="group" aria-labelledby="tfa_2334461303896-L" data-tfa-labelledby="-L tfa_2334461303896-L">
<label id="tfa_2334461303896-L" class="label preField ">Autentication</label>
<div class="inputWrapper"><span id="tfa_2334461303896" class="choices vertical "><span class="oneChoice"><input type="checkbox" value="tfa_2334461303897" class="" id="tfa_2334461303897" name="tfa_2334461303897"
aria-labelledby="tfa_2334461303897-L" data-tfa-labelledby="tfa_2334461303896-L tfa_2334461303897-L"><label class="label postField" id="tfa_2334461303897-L" for="tfa_2334461303897"><span
class="input-checkbox-faux"></span>PSK</label></span><span class="oneChoice"><input type="checkbox" value="tfa_2334461303898" class="" id="tfa_2334461303898" name="tfa_2334461303898" aria-labelledby="tfa_2334461303898-L"
data-tfa-labelledby="tfa_2334461303896-L tfa_2334461303898-L"><label class="label postField" id="tfa_2334461303898-L" for="tfa_2334461303898"><span class="input-checkbox-faux"></span>AES/TKIP</label></span><span
class="oneChoice"><input type="checkbox" value="tfa_2334461303899" class="" id="tfa_2334461303899" name="tfa_2334461303899" aria-labelledby="tfa_2334461303899-L" data-tfa-labelledby="tfa_2334461303896-L tfa_2334461303899-L"><label
class="label postField" id="tfa_2334461303899-L" for="tfa_2334461303899"><span class="input-checkbox-faux"></span>EAP-PEAP</label></span></span></div>
</div>
<div class="htmlSection" id="tfa_2334461303909">
<div class="htmlContent" id="tfa_2334461303909-HTML">
<p class="MsoNormal"><span style="font-size:8.0pt;line-height:107%">Note: EAP-TLS digital certificate authentication is not supported</span></p>
</div>
</div>
<div id="tfa_2334461303902" class="section inline group">
<div class="oneField field-container-D " id="tfa_2334461303900-D">
<label id="tfa_2334461303900-L" class="label preField " for="tfa_2334461303900">PSK Key</label>
<div class="inputWrapper"><textarea id="tfa_2334461303900" name="tfa_2334461303900" title="PSK Key" class=""></textarea></div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303901-D">
<label id="tfa_2334461303901-L" class="label preField " for="tfa_2334461303901">User Name</label>
<div class="inputWrapper"><textarea id="tfa_2334461303901" name="tfa_2334461303901" title="User Name" class=""></textarea></div>
</div>
</div>
<div class="oneField field-container-D " id="tfa_2334461303903-D">
<label id="tfa_2334461303903-L" class="label preField " for="tfa_2334461303903">Password</label>
<div class="inputWrapper"><textarea id="tfa_2334461303903" name="tfa_2334461303903" title="Password" class=""></textarea></div>
</div>
</fieldset>
</fieldset>
<div class="htmlSection" id="tfa_2334461304070">
<div class="htmlContent" id="tfa_2334461304070-HTML">
<p class="MsoNormal"><span style="font-size:8.0pt;line-height:107%">By submitting this site survey questionnaire, the Hospital/Organization warrants that the information provided above is accurate and grants permission to Intuitive Surgical to
network its ION system/Planpoint to its network as structured above for its intended purposes. Given that the Hospital/Organization owns and manages its network infrastructure and configuration, Intuitive Surgical cannot be, and is
not responsible for any network changes, disturbances, interruptions of service or suboptimal performance that may result from changes out of Intuitive Surgical’s control</span></p>
<p class="MsoNormal"><span style="font-size:8.0pt;line-height:107%">Intuitive Surgical and its affiliates within the Intuitive Surgical group of companies (collectively, “Intuitive”) may collect data relating to your use of Intuitive products
(“Data”). In some instances, Data may be communicated via data gathering or transmission technology to Intuitive. In other instances, Intuitive may require you to provide Data to Intuitive. Such Data may be used for a
variety of purposes, including, but not limited to (1) providing support and preventative maintenance of Intuitive products, (2) improving Intuitive products or services, (3) ensuring compliance with applicable laws and regulations, and (4)
providing a general resource for Intuitive’s research and business development. Intuitive does not intend to collect protected health information (PHI) as defined by the Health Insurance Portability and Accountability Act of 1996
(HIPAA) or analogous foreign patient privacy laws or regulations, as may be amended from time to time. In the event any Data communicated to Intuitive identifies an entity or individual, Intuitive will not share such Data with any
third parties without the entity’s or individual’s consent, unless required by law or regulatory authorities.</span></p>
</div>
</div>
<div class="actions" id="412383-A">
<div id="google-captcha" style="display: block;">
<br>
<div class="captcha">
<div class="oneField">
<div class="g-recaptcha" id="tfa_captcha_text">
<div style="width: 304px; height: 78px;">
<div><iframe title="reCAPTCHA"
src="https://www.google.com/recaptcha/enterprise/anchor?ar=1&k=6LfMg_EaAAAAAMhDNLMlgqDChzmtYHlx1yU2y7GI&co=aHR0cHM6Ly93d3cudGZhZm9ybXMuY29tOjQ0Mw..&hl=en&v=pn3ro1xnhf4yB8qmnrhh9iD2&theme=light&size=normal&cb=s0njnscnf9py"
width="304" height="78" role="presentation" name="a-85ok65p8j2l0" frameborder="0" scrolling="no"
sandbox="allow-forms allow-popups allow-same-origin allow-scripts allow-top-navigation allow-modals allow-popups-to-escape-sandbox"></iframe></div><textarea id="g-recaptcha-response" name="g-recaptcha-response"
class="g-recaptcha-response" style="width: 250px; height: 40px; border: 1px solid rgb(193, 193, 193); margin: 10px 25px; padding: 0px; resize: none; display: none;"></textarea>
</div><iframe style="display: none;"></iframe>
</div>
<div class="g-captcha-error"></div>
<br>
</div>
<div class="captchaHelp">reCAPTCHA helps prevent automated form spam.<br>
</div>
<div id="disabled-explanation" class="captchaHelp" style="display: block;">The submit button will be disabled until you complete the CAPTCHA.</div>
</div>
</div>
<input type="submit" data-label="submit" class="primaryAction" id="submit_button" value="submit" disabled="">
</div>
<div style="clear:both"></div>
<input type="hidden" value="750-2a1d8f30312032ea9ba73d695b6f0740" name="tfa_dbCounters" id="tfa_dbCounters" autocomplete="off"><input type="hidden" value="412383" name="tfa_dbFormId" id="tfa_dbFormId"><input type="hidden" value=""
name="tfa_dbResponseId" id="tfa_dbResponseId"><input type="hidden" value="7ad2c873d3530a9d01b5da29566760be" name="tfa_dbControl" id="tfa_dbControl"><input type="hidden" value="" name="tfa_dbWorkflowSessionUuid"
id="tfa_dbWorkflowSessionUuid"><input type="hidden" value="1670868043" name="tfa_dbTimeStarted" id="tfa_dbTimeStarted" autocomplete="off"><input type="hidden" value="80" name="tfa_dbVersionId" id="tfa_dbVersionId"><input type="hidden"
value="saveAndResumeFieldset" name="tfa_switchedoff" id="tfa_switchedoff">
<div class="saveAndResume">
<div class="oneField">
<a href="#" id="tfa_saveForLaterLink">Save my progress and resume later</a> |
<a href="https://www.tfaforms.com/forms/resume/412383" onclick="return confirm('Are you sure you want to resume a previous response? Any information you just entered on this page will be discarded.');">Resume a previously saved form</a>
</div>
</div>
</form>Text Content
ION SYSTEM ONSITE SURVEY Save my progress and resume later | Resume a previously saved form Resume Later In order to be able to resume this form later, please enter your email and choose a password. Your Email: A Password: Confirm Password: The information provided in this site survey will be used by Intuitive Surgical Field Engineers to properly configure the ION system to the hospital network for the purposes of uploading service logs to Intuitive OnSite Server. Click here to get more information on the ION system. If you have any questions you can call our Product Networking Technical Support Staff at 1 866 225-2071 or email PND@intusurg.com. Hospital Name Address City State Zip Code Customer Contact Title Phone Number Email IT Primary Contact Name Phone Number Email The ION endoluminal system consists of 2 components: the ION system cart and the PlanPoint laptop, each device requires a private IP. The Planpoint and the ION require access to OnSite URLs. While the Planpoint and ION system cart are networked they do not communicate with each other; there are no network interconnectivity requirements between the 2 devices. Required Internet Access OnSite for the ION system and PlanPoint requires access via an outbound TCP/IP port 443 communication to: PlanPoint Laptop · ionps.davinci-onsite.com 199.87.79.194 · ION System Cart ion davinci-onsite.com 199.87.79.193 Intuitive does not require any inbound access. OnSite enables log uploads; timely access to these device logs enhances Intuitive’s ability to service the ION solution. Device logs do not contain any patient information.. Web Proxy ION system or Planpoint does not support a web (https) proxy; neither device has a web browser nor allows a user to navigate a network. If a bypass is required, please provide expected date to implement Date: TLS Packet Inspection Proxy The ION system and Planning Laptop utilizes an Intuitive private PKI certificate to authenticate to OnSite’s server. If deep packet inspection technologies are used, these are known to break the TLS communication and require a bypass exception. System Number (ENxxxx) Wired Connections ION SYSTEM Wired Network Connection Reserved DHCP Static Intuitive to provide MAC address for interface. Please specify how the IP address will be provided to the ION system (DHCP or Static)? ION IP Address Subnet Mask Gateway Primary DNS Server Secondary DNS Server Data Jack Location Data Port Jack # Data Port Jack # PLANPOINT LAPTOP Wired Network Connection Static Reserved DHCP Intuitive to provide MAC address for interface. Please specify how the IP address will be provided to the Planpoint system (DHCP or Static)? Planpoint IP Address Subnet Mask Gateway Primary DNS Server Secondary DNS Server Data Jack Location Data Port Jack # Data Port Jack # Wireless Connections ION SYSTEM Wireless Network Connection SSID Static Reserved DHCP Intuitive to provide MAC address for interface. Please specify how the IP address will be provided to the ION system (DHCP or Static)? ION IP Address Subnet Mask Gateway Primary DNS Server Secondary DNS Server WPA2 WPA2 WPA2 Autentication PSKAES/TKIPEAP-PEAP Note: EAP-TLS digital certificate authentication is not supported PSK Key User Name Password PLANPOINT LAPTOP Wireless Network Connection SSID Static Reserved DHCP Intuitive to provide MAC address for interface. Please specify how the IP address will be provided to the Planpoint system (DHCP or Static)? Planpoint IP Address Subnet Mask Gateway Primary DNS Server Secondary DNS Server WPA2 WPA2 WPA2 Autentication PSKAES/TKIPEAP-PEAP Note: EAP-TLS digital certificate authentication is not supported PSK Key User Name Password By submitting this site survey questionnaire, the Hospital/Organization warrants that the information provided above is accurate and grants permission to Intuitive Surgical to network its ION system/Planpoint to its network as structured above for its intended purposes. Given that the Hospital/Organization owns and manages its network infrastructure and configuration, Intuitive Surgical cannot be, and is not responsible for any network changes, disturbances, interruptions of service or suboptimal performance that may result from changes out of Intuitive Surgical’s control Intuitive Surgical and its affiliates within the Intuitive Surgical group of companies (collectively, “Intuitive”) may collect data relating to your use of Intuitive products (“Data”). In some instances, Data may be communicated via data gathering or transmission technology to Intuitive. In other instances, Intuitive may require you to provide Data to Intuitive. Such Data may be used for a variety of purposes, including, but not limited to (1) providing support and preventative maintenance of Intuitive products, (2) improving Intuitive products or services, (3) ensuring compliance with applicable laws and regulations, and (4) providing a general resource for Intuitive’s research and business development. Intuitive does not intend to collect protected health information (PHI) as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) or analogous foreign patient privacy laws or regulations, as may be amended from time to time. In the event any Data communicated to Intuitive identifies an entity or individual, Intuitive will not share such Data with any third parties without the entity’s or individual’s consent, unless required by law or regulatory authorities. reCAPTCHA helps prevent automated form spam. The submit button will be disabled until you complete the CAPTCHA. Save my progress and resume later | Resume a previously saved form Contact Information