Feedback Form

Name*
First Last
Phone*
Phone Extension
Hospital*
Department*
Email*
Medical Device Model
Work Order #
Our ability to repair your medical device?*
The reliability or accuracy of our estimate?*
The professionalism and courtesy of our staff?*
Our turnaround time?*
Likelihood that you will use Total Scope again?*
Would you like to be contacted about this repair?*
Is there anything we can do to improve your medical device repair experience?*
Would you like to serve as a reference for customers interested in using Total Scope?*
Receive Emails*
Phone
This field is for validation purposes and should be left unchanged.