Hipster & Floor Cushion Survey

1. First Name: Required Question

2. Last Name: Required Question

3. Title:

4. Department:

5. Facility/Organization:

6. Address: Required Question

7. City:

8. Zip Code: Required Question

9. Telephone:

10. Email: Required Question

11. What is your overall perception of the Hipsters? Required Question

12. What is your overall perception of the floor cushions? Required Question

13. Do you currently use Hipsters or floor cushions in your fall prevention protocol? Required Question

14. What do you like most about the hipsters? Required Question

15. What do you like least about the hipsters? Required Question

16. What do you like most about the floor cushions? Required Question

17. What do you like least about the floor cushions? Required Question

18. Have you purchased a similar product? If so, from which manufacturer? Required Question

Hip Protectors:
Floor Cushion:

19. Would you like a Posey representative to contact you for free Hipster samples or a floor cushion demonstration? Required Question

20. How did you find our survey? Required Question

50%

Survey Software powered by SurveyGizmo