Procedure Packs / Tray Product Feedback
Hospital or Health Institution Name:
Customer Name:
First Name
Last Name
Date
-
Month
-
Day
Year
Today's Date
End User Name
End User Email Address
example@example.com
End User Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Pick the tray that you had the most experience with:
Please Select
Dressing Tray
Swabbing Tray
Maternity Tray
Rate the overall satisfaction of the product
Extremely dissatisfied
1
2
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5
6
7
8
9
Extremely satisfied
10
1 is Extremely dissatisfied, 10 is Extremely satisfied
Do you feel that the product serves its intended purpose?
Absolutely Not
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5
6
7
8
9
Absolutely Yes
10
1 is Absolutely Not, 10 is Absolutely Yes
What do you feel are the best parts of our dressing/swabbing/maternity tray components?
What problems have you previously had with this product?
Rate the following aspects of our product
The peel strength upon opening the tray
very poor
1
2
3
4
5
6
7
8
9
very good
10
1 is very poor , 10 is very good
Packaging of the components including primary packaging, and secondary packaging.
very poor
1
2
3
4
5
6
7
8
9
very good
10
1 is very poor, 10 is very good
Ease of Use of the dressing/swabbing tray
very poor
1
2
3
4
5
6
7
8
9
very good
10
1 is very poor, 10 is very good
Shape and size of dressing/swabbing tray components
very poor
1
2
3
4
5
6
7
8
9
very good
10
1 is very poor, 10 is very good
Overall quality of the contents of the tray
very poor
1
2
3
4
5
6
7
8
9
very good
10
1 is very poor, 10 is very good
Are there any recommendations for improvement of the product?
Do we meet your delivery requirements:
Yes
No
Are there any post-delivery activities that you require?
Submit
Should be Empty: