Feedback Form

Please print this, fill it out, and fax it to the number below.

Have you had a positive experience using Symptom Survey Maestro that you would like to tell us about?

Is there anything that you would like us to change in Symptom Survey Maestro to make it better?

May we publish your answers to encourage others to try Symptom Survey Maestro?  ____ Yes    ___ No

Name _______________________________   Date ___________  Signature __________________

Thank you in advance for your input.  We are always striving to make Symptom Survey Maestro a better product.

Greene Software

Phone: (585) 924-4456

Fax (585) 924-8547 or 585-486-1947

Email: sales@surveymaestro.com