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2010
December
H
HEP
HEP
Health Care Equiptment Provider
0%
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Hello:
You are invited to participate in our survey Health Care Equiptment Provider. In this survey, approximately 5 people will be asked to complete a survey that asks questions about Health Care Equiptment Provider. It will take approximately 3 minutes to complete the questionnaire.
Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.
Your survey responses will be strictly confidential and data from this research will be reported only in the aggregate. Your information will be coded and will remain confidential. If you have questions at any time about the survey or the procedures, you may contact our Managment Department at 555-5555 or by email at the email address specified below.
Thank you very much for your time and support. Please start with the survey now by clicking on the
Continue
button below.
I Agree
How old are you ?
-- Select --
18 - 20
21 - 24
25 - 29
30 - 35
50 or over
Are you Male or Female?
-- Select --
Male
Female
How often do you shop at our store?
Daily
Weekly
Monthly
Do your deliveries arrive on time ?
Yes
No
Do you find our operating hours sufficient ?
Yes
No
On a scale of 1 to 5, 1 being worst and 5 being best.
How was our customer service?
1
2
3
4
5
Would you recommend our services, equipment and supplies to others ?
Yes
No
What product would you like to see in the store?
How can we improve or better suite your needs?
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