Evaluation

I am a:
   Healthcare Professional/Caregiver
   Patient
   Supplier
How did you hear about Nu-Hope?
   Ostomy Nurse
   Hospital
   Pharmacy/DME
   Friend
   Local Support Group
   Internet
   Phoenix Magazine
Trial Sample or Purchase:
   Pouch
   Belt
   Other
Instructions:
   Excellent
   Good
   Fair
   Unsatisfactory
Quality of Materials:
   Excellent
   Good
   Fair
   Unsatisfactory
Closure (Clamp, Cap and/or Roll-up):
   Excellent
   Good
   Fair
   Unsatisfactory
Comfort:
   Excellent
   Good
   Fair
   Unsatisfactory
Ease of use:
   Excellent
   Good
   Fair
   Unsatisfactory
How do you rate the product Overall?
   Excellent
   Good
   Fair
   Unsatisfactory

  Comments:

If this was a sample, will you purchase this product?
   Yes
   No
First Name:
Last Name:
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