QuestIOnnaIRe
1. Method of purchase: (check all that apply)
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Medicare
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Insurance
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Medicaid
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Other
2. This product was purchased for use by: (check one)
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Self
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Parent
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Spouse
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Other
3. This product was purchased for use at:
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Home
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Facility
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Other
4. I purchased a Graham-Field product because:
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Price
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Features (list features)
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Other
5. Who referred you to Graham-Field products? (check all that apply)
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Doctor
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Therapist
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Friend
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Relative
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Dealer/Provider
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Other
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Advertisement (circle one): TV, Radio, Magazine, Newspaper
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No Referral
6. What additional features, if any, would you like to see on this
product?
7. Would you like to receive information about Graham-Field products
that may be available for a particular medical condition?
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Yes
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No
If yes, please list any condition(s) here and we will send you
information by email and/or regular mail about any available
Graham-Field products that may help treat, care for or manage such
condition(s):
8. Would you like to receive updated information via email or regular
mail about Graham-Field home medical products?
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Yes
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No
9. What would you like to see on the Graham-Field website?
10. Would you like to be part of future surveys for Graham-Field
products?
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Yes
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No
11. User’s year of birth:_______________
If at any time you wish not to receive future mailings from us, please
contact us at GF Health Products, Inc., 2935 Northeast Parkway,
Atlanta, GA 30360, 800-347-5678
To find more information about our products, visit www.grahamfield.com
Содержание John Bunn O2 Premier JB0160-010
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Страница 26: ...Affix first class postage here GF Health Products Inc 2935 Northeast Parkway Atlanta GA 30360...
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