First Name:
Last Name:
Address
City:
State:
Zip Code:
E-mail Address
Phone Number:
Are you?
Are You?
Your annual household income:
1. What Knit-Rite brand did you purchase at this time?
If feedback is for a compression product proceed to question #2. If feedback is for SmartKnit, SmartKnitKIDS, or Therasock products please skip to question #7.
2. Have you worn compression hosiery before?
3. If yes, what brand?
4. Date of Purchase (MM/YY)
5. Which style did you purchase at this time?
6. What compression level?
7. Please provided the 11 digit LOT# that is located on the bottom label of the box.
8. Where did you purchase your Knit-Rite product?
9. What caused you to purchase? (Check all that apply)
9a. If other, please specify:
10. How many pairs did you purchase?
11. On a scale of 1 to 10 how would you rate the following:
Quality
Fit
Comfort
Price
Overall Satisfaction
12. Would you be willing to help us with future projects or in testing new products?
13. Comments / Questions:
14. We occasionally send special promos or new product information to customers. Would you like to receive these special offers?
15. Please provide your E-Mail Address if you would like to receive promos or new product information.
