Lucas Lifecare Customer Service Survey
Lucas Lifecare strives to build world class equipment. Help us improve by leaving feedback.
Date
*
-
Month
-
Day
Year
Date
Company Name
*
Facility name
Contact Name
First Name
Last Name
Email (if follow up is desired)
example@example.com
Product
*
Please Select
LifeRay
LifeRay +
Life Ultra
Multiple
Products covered in review
Feed Back Type
Service
Installation
Other
Overall Satisfaction of Service
*
On a scale of 1-10 please rate the quality
Product Training
User Instruction
Product Function
Response to Feedback
Overall satisifaction
Total Score
How can we improve our service?
Submit
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