Name *
E-mail Address *
How old is the child that uses the oxyphone?
Less than 2 years
Older than 2 younger than 6
older than 6
Which version of the Oxyphone do you have?
Wired version
Battery-powered version
Both
Frequency of Use
Once per week
Once per day
More than once per day
How did you hear about the Oxyphone?
Websearch for pediatric nebulizer
Websearch for asthma in kids
From another parent
From a support group
From my doctor
Because of an ER/hospital visit
Will you recommend the Oxyphone to others?
Yes
no
Will you buy another Oxyphone?
Yes
No
If not, please tell us why
What can we do to make the Oxyphone better?
Was the Website useful?
Yes
No
Order and Checkout Experience
Was easy, no problems
Was difficult, had problems
Please add your comments about the Oxyphone
May we contact you about your suggestions or comments?
Yes
No
