Whitney Products, Inc. - Lab Professional Survey

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800-338-4237

Collect contaminated waste right at your workstation.

No need to make unnecessary trips to your central disposal site.

Whitney Products, Inc. - Lab Professional Survey Form


Fields with * are required

Name*:
Title:
Department:
Hospital, Company, or Facility*:

Address*:
City*:
State*:	Zip*: -
Phone*:	FAX:
E-Mail*:
Facility Type*:
Specify:
Facility Size*:	Number:
Budget*:	Your lab's annual budget for lab supplies
Purchasing Role*:
Purchasing Authority*:
Biggest problem you face daily in the lab?*:

Pet peeve in the lab?*

Favorite lab product (of any type, by any manufacturer)*:

We use the following Whitney Products:
		Please send me a sample:
	Biohazard Bench-Top Keepers™
	Biohazard Safe-Keepers™
	Terminal® Pipet Keepers™
	Terminal® Broken Glass Keepers™
	Autoclave Deodorants
	Terminal® Biohazard Bags

I read the following publications:
Advance for Laboratory Professionals	Advance for Administrators of Laboratories
American Clinical Laboratory	Clinical Lab Products
Healthcare Purchasing News	Laboratory Equipment
Laboratory Medicine	Medical Laboratory Observer
Other:	Other:
Other:	Other:
Would you be willing to participate in periodic surveys and other research on product concepts and designs and marketing programs?*
Yes No
Best way to contact you*:
E-mail Fax Mail Phone Other: Please do not contact me.

I have a great idea for a handy lab product:

Please contact me to discuss.
Other comments:

If you received a special offer code, please enter it here:

How did you hear about this survey?*

Specify:
I certify that I am employed in a laboratory as a lab manager, lab technician, or other lab-related professional.
	Yes No