Clinician Feedback Form
NOTE: This feedback form is not meant to be used to report adverse events. To report an adverse event, send an email to report@maskson.org.

Please provide feedback about your MasksOn.org Face Shield Kit below.
MasksOn.org Face Shield Kit
What is your role? *
Please tell us more about your experience ordering and receiving your Face Shield Kit
1 for Strongly Disagree & 5 for Strongly Agree
Ordering process was clear and easy
Strongly Disagree
Strongly Agree
Clear selection
I received my kit(s) quickly
Strongly Disagree
Strongly Agree
Clear selection
The kit being free was a significant factor in me ordering it
Strongly Disagree
Strongly Agree
Clear selection
Instructions and warnings were clear
Strongly Disagree
Strongly Agree
Clear selection
Instructions answered all my questions
Strongly Disagree
Strongly Agree
Clear selection
Have you used the face shield in a clinical setting? *
Next
Never submit passwords through Google Forms.
This form was created inside of MasksOn.org. Report Abuse