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* 1. How often do you place an order with Sirchie?

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* 2. Please provide your current contact information:

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* 3. Who makes the purchasing decision in your organization?

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* 4. What is the size of your organization?

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* 5. Please rate your satisfaction with Sirchie in the following areas:

  Excellent Above Average Average Below Average Very Poor
Overall satisfaction
Prices
Quality
Customer Service
Delivery

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* 6. When making a purchase, what is most important to you? Rank 1-4, with 1 being most important and 4 being least important.

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* 7. How likely are you to recommend Sirchie to a friend or colleague?

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* 8. What is the primary way you look for and get product information?

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* 9. How would you rate your Account Representative in the following?

  Excellent  Above Average  Average  Below Average  Very Poor
Knowledgeable about products
Responds to questions in a timely manner
Is Professional and Courteous
Is concerned about my organizations needs

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* 10. Have you ever attended a Sirchie training course or webinar?

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* 11. Would you like to receive communications about our products and if so, check all that apply.

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* 12. What products would you like to learn about? Please check all that apply.

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