PATIENT SATISFACTION

PATIENT SATISFACTION

We would like to know your thoughts. Please use this page to voice your concerns or your compliments.

Name (optional):
Patient name:
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Date:
Type of therapy you have been receiving:
Please circle your response to the following statements.

1. The written drug information provided by the pharmacy was:
Very good Good Average Below average
Comments:

2. The initial admission, intake process and customer service provided were:
Very good Good Average Below average
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3. Ability of our billing staff to provide prompt and accurate answers to your questions:
Very good Good Average Below Average
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4. The service from the delivery personnel was:
Very good Good Average Below Average
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5. Please rate the service provided by our staff after business hours:
Very good Good Average Below average Did not use
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6. Your overall impression with the services provided by Dottieā€™s Pharmacy pharmacy was:
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