Customer Feedback Form

Thank you for taking the time to complete our feedback survey! Your answers will be used to help improve the products and services provided by American Diagnostic Corporation.

Customer Information

Name:

Phone:

Facility/Office Name:

Occupaton:
Email:

Specialty:

Product Information

Product type purchased?
Model Number
Have you ever purchased an ADC product?
If so, which product(s)?
Packaging / Presentation:
Product Durability:
Product Performance:
Instructional Materials:
Product Design:
Value:
Accessories/Spare Parts:
Product Warranty:

Service Information

Our website / Online Information:

Please indicate the name of the dealer that you purchased this ADC product from, and provide your opinion of the following dealer related characteristics:

Dealer Name:
Courtesy:
Knowledge:
Efficiency:
Additional Comments or Suggestions: