Please select one of the following:

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* 1. Please select one of the following:

Which services did you have rendered:

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* 2. Which services did you have rendered:

How did you hear about Gastro Health Specialty Pharmacy:

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* 3. How did you hear about Gastro Health Specialty Pharmacy:

Thinking of your last visit to Gastro Health Specialty Pharmacy, how would you rate your level of satisfaction to the following:

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* 4. Thinking of your last visit to Gastro Health Specialty Pharmacy, how would you rate your level of satisfaction to the following:

  Very Satisfied Satisfied Dissatisfied Very Dissatisfied N/A
Knowledge and helpfulness of the pharmacy staff
Courtesy and friendliness of the pharmacy staff
Waiting time for your prescription
Your overall satisfaction with your experience at Gastro Health Specialty Pharmacy
Thinking of your last visit to Gastro Health Specialty Pharmacy, how would you rate your level of satisfaction to the following:

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* 5. Thinking of your last visit to Gastro Health Specialty Pharmacy, how would you rate your level of satisfaction to the following:

  Very Satisfied Satisfied Dissatisfied Very Dissatisfied N/A
Patient educational materials you may have received
Pharmacist consultation
Comfort, cleanliness and amenities of the pharmacy
The service/care provided was valuable to improving my health.

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* 6. The service/care provided was valuable to improving my health.

Would you recommend Gastro Health Specialty Pharmacy to family or friends?

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* 7. Would you recommend Gastro Health Specialty Pharmacy to family or friends?

Would you return to Gastro Health Specialty Pharmacy for future prescription fills?

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* 8. Would you return to Gastro Health Specialty Pharmacy for future prescription fills?

We would like to hear your feedback, please provide us with any comments you wish to convey to our team.

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* 9. We would like to hear your feedback, please provide us with any comments you wish to convey to our team.

Please provide us with any suggestions or recommendations for improvement.

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* 10. Please provide us with any suggestions or recommendations for improvement.

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