COSMED - LMI Installed Base Update

Venerdì 18 Maggio 2012

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LMI Installed Base Update

Primary contact (responsible/head of dept./etc)

Title

First Name

Last Name

Position

Secondary contact (technician/operator/etc.)

Title

First Name

Last Name

Position

Your company

Institute/Company

Department

Address

Zip

City

State

Country

Phone

Fax

Email

Your Product

Model name

BOD POD DOS
BOD POD Windows
BOD POD S/T
BOD POD GS
BOD POD EX
PEA POD

Serial #

Software version

Year of purchase

Purchased from

Do you have the pediatric option ?

Yes
No

Service & Support Information

Last time your product has been serviced ?

Less than 1 year ago
More than 1 year ago
Never

From which company ?

How do you rate your satisfaction concerning the level of service received ?

Excellent
Good
Fair
Poor

Do you currently have a Service Contract ?

Yes
No

If yes, please specify type of contract

If yes, with whom you have the contract in place ? (please write company name)

If yes, termination date of contract

Are you interested in learning more about service contracts available from COSMED ?

Yes, send me more information
No, not interested

Your experience

For what kind of applications do you mostly use your system ? (check all apply)

Academic and medical research
Clinical examinations
Performance assessment
Weight management
Military and public safety
Fitness and wellness
Obesity treatment
Neonatology
Other

If other, please specify

What kind of clients do you normally test ? (check all apply)

Adults
Athletes
Children
Elderly
Obese patients
Infants
Other

If other, please specify

How many tests do you perform on average ?

Do you provide public testing ?

Yes
No

Would you like to show your facility and contact details in the COSMED online locator map ?

Yes
No

Wish-list

Write here your suggestions and desired product enhancements

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