Ergonomic office furniture and workplace design services.

information

With the following information, we can give a you a professional analysis of your needs based on your situation and goals, and how an improved workplace solution might benefit your organization. Simply submit this quick survey, or if you prefer, contact us by phone or email at dennis_blaine@workplaceresourcetx.com.

We respect your company's privacy. No data you submit here will be distributed or sold by Workplace Resource to any other company, organization or individual.


Are you:
Researching Options		Planning for a future project
In need of help in servicing, repairing, or replacing an item		Developing budgets
In need of immediate assistance or information
An Architecture and Design firm


Choose from the items that you are interested in:
Seating	Systems furniture or panels		Full height wall options
Executive furniture and private offices	Wood furniture		Desks
Files or storage cabinets	Home office


Are you a current Herman Miller user?
Yes	No		Don't know


What service(s) may you be interested in hearing more about?
Furniture relocation or reconfiguration	Ergonomic Information		Project Management services
Financing or lease options	Inventory Management services		Evaluations of the effectiveness of your current work environment
Just looking for general information


How many office workers (white collar) are employed at this location?

1-5	6-25	26-100	More than 100


How would you like our consultants to reply back to you?
E-Mail	Phone	Fax	Standard Mail


Would you like to receive e-mail regarding special events, promotions or sales?
Yes	No


Would you like to receive our quarterly newsletter?
Yes	No


How was your website experience?
Great	Good	Bad


*Contact Information: Required fields indicated by ().**

First Name *
Last Name *
Title *
Address Line 1 *
Address Line 2
City *
State *		Zip Code *
Phone Number *		Fax Number *
E-Mail Address *

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