Ortho Solutions Post-Market Customer Feedback Form

CUSTOMER FEEDBACK FORM
As a valued customer we would appreciate a small amount of your time to complete the following Customer Feedback Form, our representative will complete this with you and return on your behalf.

The feedback information will be used to assess company performance, and to ensure product quality, customer satisfaction and service is achieved to the highest possible level to sustain your commitment.
Hospital Name:
Department:
Name:
Date:

Month Day Year
Date

Please provide a rating for your experience by ticking in the corresponding boxes.

Excellent

Good

Fair

Requires Improvement*

Customer Service Experience
(courtesy of staff, ease of contact)

Customer Service Response Time

Customer Support (product/information requests/technical support)

Delivery Service
(delivery time, communication of any delays)

Loan Service

Loan Kit Quality Documents

Competitiveness

Product Quality

Product Pricing

Ease of obtaining required information through the company website (www.orthosol.com)

Meeting your requirements overall

N/A Other
What makes you choose Ortho Solutions Products?
*How can we improve areas which you feel require improvement?
Signature:

Clear
Should be Empty:

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