Aftermarket evaluation form

For pharmacies and sales centers to provide post-market feedback about Mofid Darou Salamat products.

Website

Pharmacy / sales center

Pharmacy / sales center name *Registration numberCenter managerTechnical managerShift managerCenter address

Product information

Method of product useProduct usersPurpose of use (medical / cosmetic lens)Product name(s) *Approximate sales quantity for each productManufacturing dateExpiry dateBatch No.

Evaluation parameters

Product performance in lens storage

Very goodGoodAveragePoor

Comfort while using lenses

Very goodGoodAveragePoor

Eye sensitivity

NoYes

Eye infection

NoYes

Eye itching

NoYes

Lens damage

NoYes

Willingness to use again

HighMediumLow

Final information

Pharmacy / sales center commentsName of pharmacy / sales center representative *

This online form captures the operational fields of the Mofid Darou Salamat post-market evaluation record. Physical stamp/signature fields are not collected online.

Specialized Healthcare Products & Solutions

HealthcarePharmaceuticalMedical

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Retila Aroplast Colagel Oravelle Ectola

Mofid Darou SalamatTabriz · Iran