New distributors survey


Thank you for participating in this survey! 
1.Please, enter your company name:(Required.)
2.Please, writte your e-mail and phone number:(Required.)
3.Could you please describe your business?(Required.)
4.How did you know about us?
5.Please, choose your primary customer target groups:
[You can choose more than one]
(Required.)
6.How many active customers in each category do you have?(Required.)
7.Which is your business based on?
[You can choose more than one]
(Required.)
8.Which is your sales distribution model?
[Sum of all answers must be 100%]
(Required.)
9.Which are the top 5 dental brands you are distributing?(Required.)
10.Brand reference contact:(Required.)
11.Which is the number of implants placed in the market anually?
12.Which are the top 5 implants brands and aproximate market share?

13.Which is the average retail price of an implant?
14.Do you know the local applicable regulatory requirements to the import and distribution of our medical products in your market? (registration, notification of changes, traceability and complaint handling, Post Market activities etc..)
15.Do you have the necessary infrastructure to carry out these requirements (establishment or activity license, responsible technician if applicable, etc.)?
16.Would you please specify the number of employees in your company?(Required.)
17.Can you tell us how many sellers do you have ?(Required.)
18.Would you please indicate your territory coverage?(Required.)
19.Please, based on your market indicate the number of business in each category:(Required.)
20.Do you have social networks?
21.Could you write down your following links?
22.What are your sales expectations with DESS® products in the next three years?(Required.)
23.Do you have any other comments, questions, or concerns?