ANSAR CUSTOMER RELATIONS SURVEY

Are you a currently a doctor, clinician, or medical professional?(required)

Yes No

Are you currently using the ANX 3.0X autonomic monitoring technology?(required)

Yes No

Do you feel like you were properly trained on the equipment / technology?(required)

Yes No

Do you feel like the ANX 3.0X technology was easy to use?(required)

Yes No

Were your questions and concerns address promptly?(required)

Yes No

Were there any unresolved issues or concerns?(required)

Yes No

Please rate your experience as an ANSAR customer:(required)

Do you currently still have your ANX 3.0X autonomic monitoring equipment provided by ANSAR?(required)

Yes No Not Sure