YOUR FEEDBACK MATTERS TO US
Tell us what you think


Please answer the following questions in helping us to better serve your needs:

*-Information required before submitting registration

*1. How did you first learn or find out about us?

Internet web search E-mail from us or one of our affiliates Postcard mailpiece Word of mouth Courtesy phone call from us Visit from us in person Other, please explain


*2. Are you an existing customer or have purchased products/services from us before?

Yes No


3. If answered yes to question # 2 -
Based upon your most recent service, how would you rate your overall satisfaction with us?

Excellent Good Fair Poor


*4. How many microscopes do you have?

none one two three four five 6-10 11-20 21-30 31-50 51-100 100+ Don't Know


*5. Approximately about how many microscopes do you regularly use?

none one two three four five 6-10 11-20 21-30 31-50 51-100 100+ Don't Know


6. Which brand(s)/model(s) of microscope(s) do you or your organization currently use?


*7. What matters most to you if you were to purchase microscope equipment versus quality and price?

Least Expensive (quality really doesn't matter)
Cheaply Priced (quality okay with minimum requirements needed)
Economically Priced (quality good meeting or exceeding requirements needed)
Most Expensive (highest of quality with all the bells and whistles)


8. What is your microscope field of study or application use?


9. How often do you or your organization have your microscope(s) professionally cleaned (preventative maintenance)?

quarterly basis twice a year once a year rarely never


*10. Are you or your organization currently using another company to maintain microscope(s)?

Yes No


*11. Are you or your organization currently under a microscope service contract agreement with another company?

Yes No


12. If answered yes to question # 11 -
Would you like to be contacted by Valley Microscope prior to re-newing service contract?

Yes - When does your contract expire?
No


*13. Does your agency/organization announce request for proposals or bid opportunities for microscope service(preventative maintenance) or microscope equipment needed?

Yes - Where is this information posted?
No


*14. How many autoclaves do you or your organization use?

none one two three four five or more


*15. How many centrifuges do you or your organization use?

none one two three four five or more


*16. Would you like more information or new updates on the following products as it becomes available?

Please check all that apply: autoclaves centrifuges digital microscope cameras microscopes none


*17. Do you anticipate or plan on purchasing any one of the following products within the next 12 months?

Please check all that apply: autoclave centrifuge digital microscope camera microscope not sure


*18. Would you like for Valley Microscope to contact you in advance next time we plan on coming into your geographical area?

No Yes - Preferred method of contact: E-mail Alert Courtesy Phone Call


*19. Would you like to subscribe to our mailing list for free newsletters, special offers or promotions?

Yes No


20. Please provide suggestions or comments for ways we can better serve your needs and/or improve our service to the public.


YOUR NAME, ADDRESS AND PHONE NUMBER WILL REMAIN STRICTLY CONFIDENTIAL.
YOUR INFORMATION WILL NEVER BE RENTED OR SOLD TO THIRD PARTY AFFILIATIONS.

Company/Organization: *First/Last Name: *Address: *City,State,Zip: *Daytime phone: Ext. *E-mail Address:

Thank you for taking the time to fill out this questionaire.



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