Pascal Dental - Feedback - Quality Survey
 
  QUALITY SURVEY
 
 
  Order Number:

This can be found on your packing slip if you received the product directly from
Pascal Company, Inc. Leave blank if you received the product from a distributor.
   
 
  *Product:
     
* 1. Did you receive your product in a timely manner?  
  No
* 2. Was your shipment received in good condition?  
  No
* 3. Is the product packaging to your liking?  
  No
* 4. Were the instructions easily understood?  
  No
* 5. Is the product easy to use?  
  No
* 6. Have you used this product before?  
  No
* 7. Flavor?  
  Not Satisfied   N/A
* 8. Scent?  
  Not Satisfied   N/A
* 9. Effectiveness  
  Not Satisfied   N/A
   
  Comments / Suggestions:
 
   
 
 
  * Practice Name:
   
  * Contact:
   
  * Email:
   
  Address:
   
  Phone:
   
  * Required Field