Pharmacy Satisfaction Survey

Admin Console

Your feedback is valuable to us!

0

Rate your satisfaction level with the following aspects of the facility:

Very dissatisfied

Very satisfied

State of technology

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Cleanliness

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Orderliness

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Staff management

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Patient management

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Service

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied
0

How effective was the pharmaceutical service?
Unsatisfactory

Poor

Fair

Good

Excellent
0

Was your issue resolved?
Yes

No
0

Please elaborate

0 / 5000
0

How friendly were the pharmacists?
Not at all

Slightly

Moderately

Very

Extremely
0

What medication did your pharmacist prescribe you? Please list them below.

0 / 5000
0

Did the pharmacist listen to your concerns before finding treatment?
Yes

No
0

Please elaborate

0 / 5000
0

Was the pharmacist’s explanation of your medication clear?
Yes

No
0

Please elaborate

0 / 5000
0

How often do you use the pharmacy?
Never

Rarely

Monthly

Weekly

Daily
0

How much do you spend on medication monthly?
< $100

$100-$200

$201-$500

$501-$1000

> $1000
0

How satisfied are you with the overall experience?
Very dissatisfied

Dissatisfied

Neutral

Satisfied

Very satisfied
0

How can we improve?

0 / 5000

Never share any password-related information in this survey

Your response hasn't been recorded, please contact the survey administrator.

Your response cannot be recorded as some of the field validations take longer time to execute. We'd suggest resubmission before contacting the survey administrator for assistance.

Decimal values aren't allowed Only numeric values are allowed {0} shouldn't exceed {1} characters {0} shouldn't exceed {1} characters Please enter a valid email address Please enter the date in DD/MM/YYYY format Please enter the date in MM/DD/YYYY format Please enter the date and time in DD/MM/YYYY HH:MM AM/PM format Please enter the date and time in MM/DD/YYYY HH:MM AM/PM format Please enter the date in DD MMM YYYY format Please enter the date in MMM DD, YYYY format Please enter the date and time in DD MMM YYYY HH:MM AM/PM format Please enter the date and time in MMM DD, YYYY HH:MM AM/PM format Please enter the date in YYYY/MM/DD format Please enter the date in YYYY MMM DD format Please enter the date and time in YYYY/MM/DD HH:MM AM/PM format Please enter the date and time in YYYY MMM DD HH:MM AM/PM format Please select a date in between {0} and {1} Please select a date after {0} Please select a date before {0} Please enter a number between {0} and {1} Please enter a number larger than {0} Please enter a number smaller than {0} Text must be between {0} and {1} characters File name should be less than 150 characters File name should have at least 1 character Allowed file extensions are {0} File extension is not valid File size must be less than {0} File size should not be 0 File size must be between {0} and {1} Please upload exactly {0} file(s) Please upload files between {0} and {1} File limit should not exceed {0} Your file name can't contain the characters (* | / ; & < > " ?) Name can't exceed 100 characters Signature can contain only letters and the following special characters (.()-_;) File size can't exceed 10 MB Tap over the highlighted items to view the errors Text must be between {0} and {1} characters Some items have the same ranking The {0} survey is loading. {0} out of {1} responses have not been uploaded. This could be due to changes made in the survey by the administrator. Please enter valid content out of {{sum}} If you click {0}, your location will be shared with this application's owner on submitting this form

You can use this unique link to come back and fill in your survey anytime

Survey link

Get notified

Enter your email address to receive the unique survey link via email

0

Rate your satisfaction level with the following aspects of the facility:

Very dissatisfied

Very satisfied

State of technology

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Cleanliness

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Orderliness

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Staff management

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Patient management

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied

Service

Very dissatisfied

Very satisfied

1 Very dissatisfied

2

3

4

5 Very satisfied
0

How effective was the pharmaceutical service?
Unsatisfactory

Poor

Fair

Good

Excellent
0

Was your issue resolved?
Yes

No
0

Please elaborate

0 / 5000
0

How friendly were the pharmacists?
Not at all

Slightly

Moderately

Very

Extremely
0

What medication did your pharmacist prescribe you? Please list them below.

0 / 5000
0

Did the pharmacist listen to your concerns before finding treatment?
Yes

No
0

Please elaborate

0 / 5000
0

Was the pharmacist’s explanation of your medication clear?
Yes

No
0

Please elaborate

0 / 5000
0

How often do you use the pharmacy?
Never

Rarely

Monthly

Weekly

Daily
0

How much do you spend on medication monthly?
< $100

$100-$200

$201-$500

$501-$1000

> $1000
0

How satisfied are you with the overall experience?
Very dissatisfied

Dissatisfied

Neutral

Satisfied

Very satisfied
0

How can we improve?

0 / 5000