Invacare IRC10LX Respiratory Product User Manual


 
1. Method of purchase: (check all that apply)
Medicare Insurance Medicaid Other
2. This product was purchased for use by: (check one)
Self Parent Spouse Other
3. Product was purchased for use at:
Home Facility Other
4. I purchased an Invacare product because:
Price Features (list features)
5. Who referred you to Invacare products? (check all that apply)
Doctor Therapist Friend Relative Dealer/Provider Other
Advertisement (circle one): TV, Radio, Magazine, Newspaper No Referral
6. What additional features, if any, would you like to see on this product?
_________________________________________________________________
7. Would you like information sent to you about Invacare products that may be
available for a particular medical condition? Yes No
If yes, please list any condition(s) here and we will send you information by email and/or
mail about any available Invacare products that may help treat, care for or manage such
condition(s):
_________________________________________________________________
8. Would you like to receive updated information via email or regular mail about the
Invacare home medical products sold by Invacare's dealers? Yes No
_________________________________________________________________
9. What would you like to see on the Invacare website?
_________________________________________________________________
10. Would you like to be part of future online surveys for Invacare products? Yes
No
11. User's Year of birth: _________________
If at any time you wish not to receive future mailings from us, please contact us at Invacare
Corporation, CRM Department, 39400 Taylor Parkway, Elyria, OH 44035, or fax to
877-619-7996 and we will remove you from our mailing list.
TO FIND MORE INFORMATION ABOUT OUR PRODUCTS, VISIT
WWW.INVACARE.COM