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Corporate Contact Us Info Request Product Registration Product Focus Survey WebMail SR Scales SR Vet SR Mariner Violab SR OEM Owners Manuals Terms and Conditions		Product Focus Survey Your comments let us know that we are doing well and where we can improve. Please complete this brief survey. Which SRScales model was purchased? What is the Serial Number? What type of facility is the product being used in? Hospital Nursing Home Outpatient/Clinic Physician Office Veterinary Other If other, please specify: How frequently is this product used? Less than once a week More than once a week Once a week What other brands of this product type have you purchased in the past year? Detecto Health-O-meter Scaletronix Seca SR Scales Tanita None Other Please rate your satisfaction with these factors: How would you rate the condition of the packaging? Excellent Good Average Fair Poor N/A Were all the parts included? Yes No How would you rate the instructions for assembly? Excellent Good Average Fair Poor N/A How would you rate the ease of assembly? Excellent Good Average Fair Poor N/A How would you rate our company to our competitor for overall product quality? Excellent Good Average Fair Poor N/A If required, how would you rate our Technical Service support? Excellent Good Average Fair Poor N/A How would you rate our Sales/Customer Service support? Excellent Good Average Fair Poor N/A What are your improvement suggestions for our products or service? What would best describe your job title/function? Administration Biomedical Facility/Maintenance Nursing Services Veterinary Other If other, please specify: Your name: Facility name: Address: Dept/Floor: City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Zip code: Country: Telephone: Fax: Yes No Please send me a complementary "thank you" gift to the above address. This information is for SR Instruments, Inc. use only.
		As of our last business day of the year (12/22/06) SR Instruments will be discontinuing the Mariner line 600 Young Street • Tonawanda, NY 14150 • Phone 800.654.6360 • Fax 716.693.5854