Doctor Name
*
Office Phone Number
*
Email
*
How many doctors are in your practice?
*
1
2
3
4
5
5-10
10-15
15+
What days is your office open? Select all that apply.
*
Monday
Tuesday
Wednesday
Thursday
Friday
Do you work at or own any other offices?
*
No
Yes. List other office(s) address and phone number:
Rate your satisfaction of Garrison® as a business regarding customer service/sales staff.
*
Very satisfactory
Somewhat satisfactory
Neutral
Somewhat unsatisfactory
Very unsatisfactory
Rate your satisfaction of Garrison® as a business regarding product knowledge.
*
Very satisfactory
Somewhat satisfactory
Neutral
Somewhat unsatisfactory
Very unsatisfactory
Rate your satisfaction of Garrison® as a business regarding clinical knowledge.
*
Very satisfactory
Somewhat satisfactory
Neutral
Somewhat unsatisfactory
Very unsatisfactory
Rate your satisfaction of Garrison® as a business regarding product value.
*
Very satisfactory
Somewhat satisfactory
Neutral
Somewhat unsatisfactory
Very unsatisfactory
Rate your satisfaction of Garrison® as a business regarding shipping of the product.
*
Very satisfactory
Somewhat satisfactory
Neutral
Somewhat unsatisfactory
Very unsatisfactory
Rate your satisfaction of Garrison® as a business regarding meeting the customers' needs.
*
Very satisfactory
Somewhat satisfactory
Neutral
Somewhat unsatisfactory
Very satisfactory
What would you like to see in our email communications? Select all that apply.
*
More frequent special offers
More enticing offers (bigger discounts, buy one get one, etc.)
Detailed clinical information
Product tips and tricks
Nothing - please don't email me
Other email communication requests:
Is there a product that you "wish someone would invent?" If yes, explain.
*
Do you exclusively use Garrison® Wedges?
*
Yes
If no, what brand do you use and why?
Do you exclusively use Garrison® Matrix Bands?
*
Yes
If no, what brand do you use and why?
Do you exclusively use Garrison® Separator Rings?
*
Yes
If no, what brand do you use and why?
What improvements/changes would you like to see in the Garrison® products you use? Please list product and improvement(s)/change(s).
*
Have you seen or heard about our new Rally™ Mini Polishers for Composite?
*
Yes
No
Have you seen or heard about our new FitStrip™ Flexible Interproximal Finishers?
*
Yes
No
Who makes the buying decisions in your office? Select all that apply.
*
Doctor
Assistant
Office Manager
Office Staff
Hygienist
Other
Who does the purchasing in your office? Select all that apply.
*
Doctor
Assistant
Office Manager
Office Staff
Hygienist
Other
Would you prefer a $10 Starbucks gift card or a $20 Garrison® discount? (Discount must be used on or before 7/31/2017).
*
$10 Starbucks gift card
$20 Garrison® discount