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Product Focus Survey
Your comments let us know that we are doing well and where we can improve. Please complete this brief survey.
Which SRScales model was purchased?
What is the Serial Number?
What type of facility is the product being used in?
Hospital
Nursing Home
Outpatient/Clinic
Physician Office
Veterinary
Other
If other, please specify:
How frequently is this product used?
Less than once a week
More than once a week
Once a week
What other brands of this product type have you purchased in the past year?
Detecto
Health-O-meter
Scaletronix
Seca
SR Scales
Tanita
None
Other
Please rate your satisfaction with these factors:
How would you rate the condition of the packaging?
Excellent
Good
Average
Fair
Poor
N/A
Were all the parts included?
Yes
No
How would you rate the instructions for assembly?
Excellent
Good
Average
Fair
Poor
N/A
How would you rate the ease of assembly?
Excellent
Good
Average
Fair
Poor
N/A
How would you rate our company to our competitor for overall product quality?
Excellent
Good
Average
Fair
Poor
N/A
If required, how would you rate our Technical Service support?
Excellent
Good
Average
Fair
Poor
N/A
How would you rate our Sales/Customer Service support?
Excellent
Good
Average
Fair
Poor
N/A
What are your improvement suggestions for our products or service?
What would best describe your job title/function?
Administration
Biomedical
Facility/Maintenance
Nursing Services
Veterinary
Other
If other, please specify:
Your name:
Facility name:
Address:
Dept/Floor:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Iowa
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Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
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Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Zip code:
Country:
Telephone:
Fax:
Yes
No
Please send me a complementary "thank you" gift to the above address.
This information is for SR Instruments, Inc. use only.
600 Young Street • Tonawanda, NY 14150 • Phone 800.654.6360 • Fax 716.693.5854