Dynadress Product Feedback
Hospital or Health Institution Name:
Customer Name:
First Name
Last Name
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Today’s Date
End Username
End User Email
example@example.com
End User Contact Number
Please enter a valid phone number.
Format: (000) 000-0000.
Pick the dressing that you had the most recent experience with:
Please Select
Transparent PU IV Fixation Dressing with Pad and Slit 7x9
Transparent IV Dressing Frame Style 10x12
Transparent IV Fixation Dressing 10x12 - With U-Notch
Transparent IV Dressing Frame Style 6x7
Rate the overall satisfaction of the product from 1-10
Extremely Dissatisfied
1
2
3
4
5
6
7
8
9
Extremely Satsified
10
1 is Extremely Dissatisfied, 10 is Extremely Satsified
Do you feel that the product serves its intended purpose?
Absolutely Not
1
2
3
4
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 product?
What problems have you previously had with this product?
Rate the following aspects of our product from 1-10 where 1 = very poor and 10 = very good
The pouch seal strength
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 dressings 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
The peel strength of the siliconized release paper.
Very poor
1
2
3
4
5
6
7
8
9
Very good
10
1 is Very poor, 10 is Very good
The peel strength of the PET/Paper carrier (used as the frame or release once dressing is on the skin)
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
Very poor
1
2
3
4
5
6
7
8
9
Very good
10
1 is Very poor, 10 is Very good
Dressing adhesion to different skin types, and to different parts of the body
Very poor
1
2
3
4
5
6
7
8
9
Very good
10
1 is Very poor, 10 is Very good
Dressing shape, and size
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 dressing
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: