Feedback

Customer Feedback Form

Please complete the following questions to receive your complimentary Sheaffer writing pen.

Name:

*

Position:

*

Health facility:

*

Email Address:

*

Street Name:

*

City:

*

State:

*

Postcode:

*

Phone Number:

Have you had any previous dealings with Hipac?:

*

If this is your first experience, how did you come to know about us?:

From time to time we offer special promotions and new product updates. What is your preferred method of delivery?:

*

How do you rate the quality of our products?:

*

How do you rate your experience dealing with our Customer Care Team?:

*

How do you rate our delivery times?:

*

We foster long lasting relationships. We invite you to share with us any suggestions you may have on how we can make your future dealings with Hipac even better:

Thank you for taking the time to complete this survey. We value your feedback and look forward to working with you into the future.