Support Therapy Feedback Form: Web & Response Cards
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1. Support Therapy Feedback Form
Thank you for sharing your opinion on your SIGVARIS garments, as your feedback helps us create better products for everyone! This form should take less than 5 minutes to complete.
. Do you give your consent for SIGVARIS to share your feedback within sales or marketing programs? Besides your name, your personal information will not be disclosed [i.e. height, weight, etc.]
Do you give your consent for SIGVARIS to share your feedback within sales or marketing programs? Besides your name, your personal information will not be disclosed [i.e. height, weight, etc.]
Yes, I give my consent.
Yes, I give my consent, but do not share my name and/or job title.
No, I do not give my consent.
. Please provide your contact information.
Please provide your contact information.
-- select state --
AS American Samoa
DC District of Columbia
FM Federated States of Micronesia
MH Marshall Islands
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
VI Virgin Islands
WV West Virginia
Do not wish to disclose
. Your age group:
Your age group:
Do not wish to disclose
. Please enter your weight: [ex. 157 lbs.]
Please enter your weight: [ex. 157 lbs.]
. Your Height: [ex. 5 feet, 5 inches]
Your Height: [ex. 5 feet, 5 inches]
. What is your Shoe Size?
What is your Shoe Size?
. Which Support/Active Therapy products are you wearing?
Which Support/Active Therapy products are you wearing?
120 Sheer Fashion Hosiery - Knee Hi
120 Sheer Fashion Hosiery - Thigh Hi
120 Sheer Fashion Hosiery - Pantyhose
120 Sheer Fashion Hosiery - Maternity
146/186 Casual Cotton Socks
145/185 Classic Dress Socks
144/184 Athletic Recovery Sock
142/182 Cushioned Cotton Support Socks
180 Classic Ribbed Socks
. Where did you buy these?
Where did you buy these?
. What size was the product you wore?
What size was the product you wore?
. How long have you used compression therapy products?
How long have you used compression therapy products?
Less than 1 year
5 years or more
Please tell us how you feel about this product by answering the questions below.
Not Very Durable
. Would you like to make any additional suggestions or comments?
Would you like to make any additional suggestions or comments?