Contact Information

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* 1. Contact Information

Would you like to subscribe to our electronic newsletter, RazNewz?

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

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

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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)

Position: You are a (Select all that apply)

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

Product: Model Being Used

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* 5. Product: Model Being Used

Chair Serial Number:

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* 6. Chair Serial Number:

Ratings

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* 7. Ratings

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

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* 8. General Comments

What do we do well?

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* 9. What do we do well?

What can we do better?

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* 10. What can we do better?

Would you recommend Raz to other users and caregivers?

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

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