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Customer Details |
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| *Please indicate which category best defines your organization |
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Home |
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Clinic |
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Emergency services organization |
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General practice surgery |
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Home user |
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Other |
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| *Please specify the country where your organization is located. |
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| How long have you been a Haidylena customer? (Please round out to the nearest number of years.) |
| 1 |
2 |
3 |
4 |
5 |
More than 5 years |
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Experience with Haidylena For Advanced Medical Industries |
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| *With regard to the Haidylena products in particular, please indicate the areas of experience you have had with Haidylena For Advanced Medical Industries. You will be asked a few more detailed questions about the areas that you are familiar with later in the survey. (Please select all that apply) |
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Sales and product purchase |
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Product quality |
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Product usage |
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Technical support by telephone |
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Packing |
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Packaging |
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Technical support by email or chat |
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Sterilization |
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Registration |
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Technical support from Haidylena's website |
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Customer services |
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Delivery |
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Use of Haidylena's website to obtain information about the products |
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Complaint handling |
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| *Including the Haidylena products, please indicate which of the following products you are currently using: (Check all that apply) |
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Disposable hollow fiber dialyzer/ Hemofilter |
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Disposable blood line |
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Fistula needle |
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Infusion set |
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Bicarbonate cartridge |
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Transfusion set |
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Lena Cart |
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Catheter |
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Blood bags |
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Overall Impressions |
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| *Please base your answers to the following questions on your overall experience with Haidylena For Advanced Medical Industries. |
| Overall, how satisfied are you with Haidylena products? |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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| How likely is it that you would recommend Haidylena products to a patient or a friend? |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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| How likely are you to continue buying from Haidylena For Advanced Medical Industries? |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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| If you were selecting a similar solution for the first time, how likely is it that you would choose Haidylena products? |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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*Please indicate how strongly you agree or disagree with the following statements about Haidylena. Please select "N/A which means Not applicable" for any area that is not relevant to your experience.
a. Haidylena provides |
| State-of-the-art production |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Excellent value for the money |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Trustworthy products |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Premium products and services |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Products that are best in category |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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Overall Experience |
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*We are interested in your experience with Haidylena products. Please rate each of the following areas on a scale of 1 to 10, with one being the lowest score, by indicating how satisfied you are with
Haidylena product range in that area.
Please select "N/A which means Not applicable" for any area that is not relevant to your experience. |
| Overall Product Quality |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Overall Technical Support/Customer Service Experience |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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Product Experience |
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*Please rate your satisfaction with the following aspects of your experience with Haidylena product.
Please select "Not applicable" for any area that is not relevant to your experience. |
| Overall Product Performance |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Ease of use, handling, and installation |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Product labeling |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Product packing |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Product packaging |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Package insert leaflet (Directions For Use) |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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Technical Support/Customer Service Experience |
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*Please rate your satisfaction with the following aspects of Haidylena technical support and/or customer service experience.
Please select "Not applicable" for any area that is not relevant to your
experience. |
| Product delivery |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Ease of use, handling, and installation |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Product registration |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Complain handling |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Ease to use haidylena web site to obtain technical information |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
| Effectiveness of technical support on Haidylena web site |
| Completely unlikely |
Completely likely |
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| N/A |
1 |
2 |
3 |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
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Additional Comments |
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Haidylena For Advanced Medical Industries welcomes your comments and suggestions for improvement. If you wish to leave specific feedback regarding your experiences in any of the areas below, please enter your comments and suggestions in the space provided. |
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| Performance area |
Comment |
| *Correspondence sent to customer: |
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| *Product replacement: |
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| *Credit note |
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You're done! Thank you for your time. Your feedback is greatly appreciated. |
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