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  2. 2012
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  5. Test 1
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Facility Name and Address
   
 
 
 
Contact Name and Department
   
 
 
 
Survey Date
   
 
 
 
Product Surveyed
   
 
 
How would you rate the following aspects of this product?
Poor Average Good Excellent
Ease of Use
Performance
Safety
Reliability
Effectiveness
Product Installation Experience
Product Training/Education Tools
 
 
 
Please provide any additional comments, concerns, and/or recommendations that you may have regarding this or any Philips/Respironics product.
   
 
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