Abdominal Binders Product Evaluation

We value your opinion

We appreciate your input on the Dale Abdominal Binders.

Please answer the following questions:

410-920 | Binder Evaluation Form

Did you have the opportunity to use the Dale Abdominal Binder on a Patient?

Yes

Where was the procedure performed?

Hospital

Doctor's Office

Surgicenter

When was the Dale Abdominal Binder given to the patient?

Prior to the procedure

After the procedure

How many days do you typically prescribe the binder be used for?

days

What binder(s) are you currently using?

Compared to the product cited above, please tell us how the Dale Abdominal Binder compares in the following areas:

Overall, which binder do you like better?

Dale

Other

Would you recommend the Dale Abdominal Binder for regular use in your facility?

Yes

Please cite any additional comments you may have:

Please cite any additional patient comments:

Contact Information

Salutation

First Name

Last Name

Job Title

Facility

Phone/Mobile

Department

Address

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	Better	Same	Worse
Application
Comfort
Ability to hold dressing or tubing in place
Durability
Compression

Enteral Care

IV & Vascular Solutions

Post Surgical

Respiratory Care

Urology

Abdominal Binders Product Evaluation

We value your opinion

Contact Information