New FreeArm - Home Survey

Name

First Name

Last Name

1. Is the arm a helpful length? *

Yes

No

2. Does the arm loosen from the clamp after multiple uses? *

Yes

No

3. Does the flower screw holding the arm into the clamp loosen and fall out? *

Yes

No

4. Are the directions clear and easy to understand? *

Yes

No

5. Does the arm support the weight of your tube feeds? *

Yes

No

6. Are you using the FreeArm for pump feeds or gravity syringe feeds? *

Pump Feeds

Gravity Syringe Feeds

8. Did you attach your FreeArm to flat surfaces and rounded bars? *

Yes

No

9. Did the FreeArm work well on both types of surfaces? *

Yes

No

10. Do you have suggestions for improvements? *

Yes

No