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Patient
Providers
Payers
Manufacturer
340B
Specialties
Patient
Providers
Payers
Manufacturer
340B
Specialties
PATIENT SATISFACTION SURVEY
Date
Dear Patient,
It is our desire to provide you with the best quality services available. In order to help us maintain our high standards, please take a few moments to tell us how we are doing. Please complete this form and submit it to us electronically. Thank you.
Were your medications delivered on time?
Yes
No
Were the medications dispensed and delivered accurately?
Yes
No
Was the pharmacy training provided effective in educating you on your therapy?
Yes
No
Were the educational materials and instructions provided to you adequate to educate you on the medications dispensed to you?
Yes
No
Was the pharmacy staff courteous and helpful?
Yes
No
Were your financial responsibilities explained to you?
Yes
No
Do you receive advice or help from the pharmacy when needed?
Yes
No
Did the services provided have a positive impact on the outcome of your care and/or therapy?
Yes
No
Would you recommend our pharmacy to your friends and family?
Yes
No
Did the services provided meet your needs and expectations?
Yes
No
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