Compliance Medical

Survey

For taking the time to complete this brief survey we will send you a package of mint truffles.

Fire Department / Ambulance Company

Name

Last Name

Phone

Address 1

Address 2

City

State

Zip

What brand Cervical Immobilization Device do you use most often?

How many patient transports per month?

What Distributor(s) do you purchase from?

Do you use the occipital pad?

Receive a free sample of the following products:

Receive a product catalog

Note: Limit 1 per person. Offer may change from time to time.

During 2002, 45 percent of the motorcycle drivers between 15 and 20 years old who were fatally injured in crashes were not wearing helmets.