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PRODUCT FEEDBACK FORM
As your Specialist Medical Partner, We continually seek the critical path to any important breakthrough that will allow us to provide better Patient Care. Our aims are to achieve excellence and to ensure the best services provided, we greatly appreciate your time to full in this Product Feedback Form to our continue improvement of your services.

(1 General Information
Category: Salutation: Company / Institution: First Name: Last Name: E-mail: Contact Number:
(2 Product(s
1.
Product Code

2.
Product Description

(3 Product(s Comments
1. Was the product easy to operate? Excellent Satisfying Acceptable
2. Does our product meet your expectation? □ Excellent □ Satisfying □ Acceptable

3. Was the product easy to handle or operate? □ Excellent □ Satisfying □ Acceptable

4. Was the labeling / packaging sufficient? □ Excellent □ Satisfying □ Acceptable

5. Was the instruction for user clear enough? □ Excellent □ Satisfying □ Acceptable

6. How would you rate our products? □ Excellent □ Satisfying □ Acceptable
□ Inadequate
□ N/A
Distributor
Professor
Doctor End User
Mr.
Mrs.
Ms.



+( Job Title: Address:



Inadequate □ Inadequate □ Inadequate □ Inadequate □ Inadequate
□ N/A □ N/A □ N/A □ N/A □ N/A FM123A 1/2 CRxxxx
PRODUCT FEEDBACK FORM

7. Are there comments concerning our products?


(4
Services 1.
Are our staffs efficient / polite / reliable / has sufficient professional knowledge for your enquiry? □ Excellent □ Satisfying □ Acceptable □ Inadequate □ N/A

2. Are our customer support / consultation service satisfying? □ Excellent □ Satisfying □ Acceptable □ Inadequate □ N/A

3. Are our staffs cooperating enough? □ Excellent □ Satisfying □ Acceptable □ Inadequate □ N/A

4. Are our staffs cooperating enough? □ Excellent □ Satisfying □ Acceptable □ Inadequate □ N/A

8. Are there comments concerning our services?


(5
Overall 1. In General, How would you comment rate our services and products? 1 as Least Satisfactory □ Excellent □ Satisfying □ Acceptable □ Inadequate □ N/A

2. Would you recommend our products to other users?

3.
Are there any further comment relating to us?
Thank you.
We will carefully examine this questionnaire and continuously to improve our services. FM123A 2/2 CRxxxx

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