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 followup is desired)
example@example.com
Product
*
Please Select
LifeRay
LifeRay +
LifeUltra
Multiple
Products covered in review
Feedback Type
Service
Installation
Other
Overall Satisfaction of Service
*
On a scale of 1-low to 10-best, please rate the following areas:
Product Training
User Instruction
Product Function
Response to Feedback
Overall satisifaction
Total Score
How can we improve our service?
Submit
Should be Empty: