Customer Feedback
Fill in the details below to receive a 10% discount off your next purchase.
This 10% discount is only valid for the first purchase after completing this form. The promotional code will lapse
in 30 days time.

Let us know what you think by rating the following: (* denotes mandatory fields.)

Product Ordered*

(please enter product code)

Efficiency of order process/customer service*

Awful Poor Good Excellent

Delivery & condition of order*

Awful Poor Good Excellent

Ease of use/design of gel*

Awful Poor Good Excellent

Staining of gel*

Awful Poor Good Excellent N/A

Blotting of gel*

Awful Poor Good Excellent N/A

Resolution separation of protein bands*

Awful Poor Good Excellent

Technical support*

Awful Poor Good Excellent N/A

Please indicate order method*

Web Fax Telephone Email Other

How many days did it take to receive your order?*

2 or less 3 to 5 5 to 6 More than 6

Will you purchase NuSep gels in the future?*

Yes No

How did you find out about NuSep Gels?*

Ad Web Colleague Sales Rep Other

Customer Details

Name*

Phone*

Institution*

Email*

Address*

State*
Zip* (postcode)

Comments