Uniform Apparel Needs Analysis
Organization Information
Contact Name
*
First Name
Last Name
Organization / Company Name
*
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I'm interested in (select all that apply):
*
Scrubs Purchase - Group Order
Corporate Non-Medical Uniform Purchase - Group Order
Embroidery
Medical Accessories: (stethoscopes, lanyards, badges, pin lights, sphygmomanometer, etc.)
Purchase for Company Sponsored Event (Sports Event, Casual Fridays, Company Picnics, Trade Shows etc.)
What type of uniform/scrub apparel do you require?
*
Please Select
Scrub attire (tops, pants, dresses)
Collared Shirts
Polo/Sports Shirts
Pants
Lab Coats
Other
N/A
Do you require embroidery? If yes, what type?
*
Please Select
Standard Logo Embroidered
Patches
N/A
Purchase Process
How do your students/employees currently purchase scrub/uniform apparel?
*
Please Select
Employee/Student purchase on their own
Organization provides/purchases
Uniform Rental Company
How often are new scrubs/uniforms purchased/required?
*
Please Select
Weekly
Monthly
Bi-Monthly
Quarterly
Biannually
Annually
What is your budget per student/employee?
*
Please Select
<$50
$51-$150
$150-$250
$251-$350
>$350
Are you looking to keep inventory on site or purchase as needed?
*
Please Select
On-site
As needed
Unsure
N/A
Do you have multiple departments that require uniforms/scrubs
*
Please Select
Yes 2-5 departments
Yes 6-10 departments
Yes >10
No
How many students/employees require uniforms?
*
Please Select
0-10
11-25
26-50
51-150
151-300
301-500
501+
Questions or comments
How did you hear about First Class Med Apparel?
*
Please Select
Newsletter
Website
Another event
Staff member
Board Member
Poster/Flyer
Social Media (please specify in comments)
Family Member/Friend
Another party or organization
Please verify that you are human
*
Submit
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