Newport NMI Ventilators | Newport Medical Instruments

Valued Customer Survey

As an owner of Newport Medical products your satisfaction is our #1 priority. Please take a moment to answer these questions and help us ensure that we continue to maintain the highest quality service for all of our customers.

1.	Please indicate which Newport Medical products you are using and how many you own. Check all that apply.
	HT50 Ventilator	Qty:	HT70 Ventilator	Qty:
	e500 Ventilator	Qty:	E150 Ventilator	Qty:
	e360 Ventilator	Qty:	E200/VM200 Ventilator	Qty:
	E100M Ventilator	Qty:	C250 Air Compressor	Qty:

2.	Indicate your application for the(se) product(s).
	Homecare	Critical Care	Post Surgical
	Transport	Subacute	Emergency

3.	Who did you purchase your Newport Medical product(s) from?
	A. Did you receive the initial clinical education and training you requested?
	Yes	No	Don't Know
	B. Did Newport Medical or your Newport Medical Sales Representative help you to resolve any outstanding issues or challenges regarding the purchase of your Newport Medical product?
	Yes	No	Don't Know
	If no, please explain.

4.	Are the Newport Medical product user-instructions (manual) clear and useful?
	Yes	No
	If no, please give us your suggestions.

5.	Was it easy to get in touch with Newport Medical for:
	Customer Service	Yes	No
	Technical Service	Yes	No
	Clinical Service	Yes	No
	If no, please explain.

6.	Additional Issues and Comments: Feel free to comment any issue of importance to you.

7.	Would you like us to contact you? If so, please indicate your interest below.
	Product	Service	Education

Please provide your contact information.
* Name:
* Organization:
* Email:
Phone:
Address:
City:
State/Province:
Zip/Postal Code:
Country:

* Required Fields

Thank you for your time. We really value your opinion.



	Copyright © 2006 Newport Medical Instruments. All rights reserved. 1620 Sunflower Ave Costa Mesa, CA 92626, USA Tel: +1 (714) 427-5811 Toll Free: 1 (800) 451-3111 Fax: +1 (714) 427-0489