- Equality

1) Who I am *

1) specify ...

1) specify

2) on which aid have I encountered problems? *

2) other -> specification

3) the aid in question was: *

3) prescribed by the ASL -> which one

3) purchased privately -> by whom

4) identification of the aid *

5) the failure or malfunction was such as to: *

brief description of the fault

6) the failure or malfunction has occurred *

a) during the warranty period (2 years from delivery, or further in case of a specific contractual provision)
b) after the expiry of the guarantee

7) have I reported the fault? *

by phone / in writing (e.g. sms, Whatsapp, Messenger, email, letter

how many days after the failure has been verified?

8) what did I ask for? *

urgent assistance

9) what assistance have I received? *

immediate replacement / repair
immediate supply of replacement aid, pending replacement / repair
late assistance within a week / within a month / after (tick and specify after ...)
response not followed by assistance
no feedback

Additional notes

10) when did the fact happen?

11) am I overall satisfied with the service received? *

if not, why

Additional notes

Name *

Name

Last name

Email *

GDPR Agreement *