Customer Satisfaction Survey
Page One
Thank you for taking our customer satisfaction questionnaire.
It will take only 2-3 minutes to complete. We value your opinion and will use your opinions to take stock of our service and support and to make improvements.
All your answers are confidential and help us to serve you better.
1.
How did you last contact our pharmacy?
Website refill request
In Person (came to store)
Telephone
Email
Other
2.
If you remember the name of the staff member that served you, please enter their name here.
3.
General satisfaction
Very Satisfied
Satisfied
Neutral
Not Satisfied
Very Dissatisfied
N/A
Overall, how happy are you with our customer service?
Overall, how satisfied are you with our products/service?
Overall, how satisfied are you with our prices?
Overall, how satisfied are you with our convenience (ie location, hours, etc)?
4.
Please rate our pharmacists.
Click on the number of stars to rate each item.
Rating
Prompt
Courteous
Helpful
Knowledgeable
Efficient
Understood my needs
Caring
5.
Please rate our pharmacy technicians.
Click on the number of stars to rate each item.
Rating
Prompt
Courteous
Helpful
Knowledgeable
Efficient
Understood my needs
Caring
6.
Where do we need to improve most?
Please click the boxes to rank the follow areas; numbers will fill in automatically. Number 1 is the area we MOST need to improve on.
1]
Courtesy
2]
Knowledge
3]
Patience
4]
Product availability / inventory
5]
Ability to listen
6]
Pricing
7]
Wait/Hold time
8]
Friendliness
7.
Compared to our competitors, would you rate our customer service as ____
Better
The same
Not as good
N/A
8.
From a customer service prospective, would you recommend us ?
Yes
No
9.
What else could we do better? Do you have any other comments?
10.
Please add your email address if you would like us to follow up with you.
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