Name
*
Office Phone Number
*
Email
*
1. How many doctors are in your practice?
*
2. What days is your office open? Check all that apply.
*
Monday
Tuesday
Wednesday
Thursday
Friday a.m. only
Friday full day
3. Do you work at or own any other offices?
*
Yes
No
4. If you DO own/work at any other offices, please list the phone number(s) and address(es) of the practice(s) below.
Rate your satisfaction of Garrison as a business in the following areas, with 10 being very satisfied:
5. Customer service/sales staff
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
6. Product Knowledge
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
7. Clinical knowledge
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
8. Product value
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
9. Shipping of the product
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
10. Meeting the customers' needs
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
11. Garrison offers a range of CE webinars. Is there a topic(s) that you would like to have us offer? If so, what?
*
12. Is there a dental product you wish someone would invent? If so, what?
*
13. Is there a clinical problem you wish someone would solve? If so, what?
*
What clinical procedure would you like to see improved? What's difficult about it?
14. For the dentist:
15. For the assistant:
16. For the hygienist:
17. If you use Garrison RINGS, what changes would you like to see?
18. If you use Garrison MATRIX BANDS, what changes would you like to see?
19. If you use Garrison WEDGES, what changes would you like to see?
20. How likely are you to recommend Garrison products to your colleagues on a scale of 1 to 10, with 10 being extremely likely.
*
Very poor
Poor
Not that bad
Fair
Average
Almost good
Good
Very good
Excellent
Perfect
21. Why did you give that specific score?
*
22. Who makes the buying decisions in your office? Check all that apply.
*
Doctor
Assistant
Hygienist
Office Manager
General Office Staff
Other
23. Who does the purchasing in your office? Check all that apply.
*
Doctor
Assistant
Hygienist
Office Manager
General Office Staff
Other
24. Would you prefer a $10 Starbucks gift card, or a $20 Garrison discount? (Discount must be used by 7/31/2019)
*
$10 Starbucks gift card
$20 Garrison discount
PLEASE NOTE GARRISON DISCOUNT RECIPEINTS:
Thank you for choosing a $20 Garrison discount. Your discount code is RL61920. The code is valid through 7/31/2019.
PLEASE NOTE STARBUCKS GIFT CARD RECIPIENTS:
we'll be mailing your gift card to the location associated with your account with us. Please allow some time for that to reach you.*
*This does not apply if you chose to receive a $20 Garrison discount.