Raz Design Inc.
Client Survey

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* 1. Contact Information

Name

Email Address

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* 2. Would you like to subscribe to our electronic newsletter, RazNewz?

Yes

No

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* 3. Approval to use info for marketing purposes? eg. customer feedback reviews, testimonials, etc.
(Last name and email will be kept confidential)

Yes

No

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* 4. Position: You are a (Select all that apply)

User

Caregiver

Other (please specify)

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* 5. Product: Model Being Used

AT

SP

AP

CAT

AT600

SP600

AP600

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* 6. Chair Serial Number:

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* 7. Ratings

	Poor	Average	Good	Excellent
Functionality	Functionality Poor	Functionality Average	Functionality Good	Functionality Excellent
Ease of Use	Ease of Use Poor	Ease of Use Average	Ease of Use Good	Ease of Use Excellent
Comfort	Comfort Poor	Comfort Average	Comfort Good	Comfort Excellent
Durability	Durability Poor	Durability Average	Durability Good	Durability Excellent
Customization	Customization Poor	Customization Average	Customization Good	Customization Excellent
Aesthetics	Aesthetics Poor	Aesthetics Average	Aesthetics Good	Aesthetics Excellent
Overall Product Quality	Overall Product Quality Poor	Overall Product Quality Average	Overall Product Quality Good	Overall Product Quality Excellent
Customer Service	Customer Service Poor	Customer Service Average	Customer Service Good	Customer Service Excellent
Technical Support	Technical Support Poor	Technical Support Average	Technical Support Good	Technical Support Excellent
Delivery Time	Delivery Time Poor	Delivery Time Average	Delivery Time Good	Delivery Time Excellent
Documentation	Documentation Poor	Documentation Average	Documentation Good	Documentation Excellent
Website	Website Poor	Website Average	Website Good	Website Excellent

Comments

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* 8. General Comments

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* 9. What do we do well?

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* 10. What can we do better?

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* 11. Would you recommend Raz to other users and caregivers?

Yes

No

Doc #: RSD045r01 Rev. Date: 2022-11-07