Clinic Equipment Questionnaire

Gather the details you need from clinic staff to plan equipment purchases, upgrades, or replacements.

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Clinic Name

Your Name

First Name

Last Name

Position/Title

Contact Information (Email/Phone)

What type of clinic do you operate?

General practice Dental Dermatology Physical therapy Veterinary Other

What types of equipment do you currently use?

Diagnostic equipment Monitoring devices Surgical instruments Imaging equipment Laboratory equipment Other

How satisfied are you with your current equipment?

Not likely

1 2 3 4 5 6 7 8 9 10

Very likely

What equipment do you feel is lacking in your clinic?

What is your budget for new equipment?

Do you have any specific brands or models in mind?

Any additional comments or suggestions?

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