Weldricks Community Pharmacy Patient 2018-2019

Question Title

* 1. Q1. Why did you visit this pharmacy today?
To collect a prescription for:

Yourself

Someone else

Both

Other

For some OTHER reason (please write in the reason for your visit:

If you did not collect a prescription, please go to Q3.

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* 2. Q2 If you collected a prescription today, were you able to collect it straight away, did you have to wait in the pharmacy or did you come back later to collect it?

Straight away

Waited in pharmacy

Came back later

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* 3. Q3 How satisfied were you with the time it took to provide your prescription and/or any other NHS services you required?

Not at all satisfied

Not very satisfied

Fairly satisfied

Very satisfied

Please tick one box for each aspect of the pharmacy listed below, to show how good or poor you think it is:

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* 4. Q4 Thinking about previous visits as well as today's, how would you rate the pharmacy on the following factors?

	Very poor	Fairly poor	Fairly good	Very good	Don't know
a) Cleanliness of the pharmacy	a) Cleanliness of the pharmacy Very poor	a) Cleanliness of the pharmacy Fairly poor	a) Cleanliness of the pharmacy Fairly good	a) Cleanliness of the pharmacy Very good	a) Cleanliness of the pharmacy Don't know
b) The comfort and convenience of the waiting areas (e.g. seating or standing room)	b) The comfort and convenience of the waiting areas (e.g. seating or standing room) Very poor	b) The comfort and convenience of the waiting areas (e.g. seating or standing room) Fairly poor	b) The comfort and convenience of the waiting areas (e.g. seating or standing room) Fairly good	b) The comfort and convenience of the waiting areas (e.g. seating or standing room) Very good	b) The comfort and convenience of the waiting areas (e.g. seating or standing room) Don't know
c) Having in stock the medicines/appliances you need	c) Having in stock the medicines/appliances you need Very poor	c) Having in stock the medicines/appliances you need Fairly poor	c) Having in stock the medicines/appliances you need Fairly good	c) Having in stock the medicines/appliances you need Very good	c) Having in stock the medicines/appliances you need Don't know
d) Offering a clear and well organised layout	d) Offering a clear and well organised layout Very poor	d) Offering a clear and well organised layout Fairly poor	d) Offering a clear and well organised layout Fairly good	d) Offering a clear and well organised layout Very good	d) Offering a clear and well organised layout Don't know
e) How long you have to wait to be served	e) How long you have to wait to be served Very poor	e) How long you have to wait to be served Fairly poor	e) How long you have to wait to be served Fairly good	e) How long you have to wait to be served Very good	e) How long you have to wait to be served Don't know
f) Having somewhere available where you could speak without being overheard, if you wanted to	f) Having somewhere available where you could speak without being overheard, if you wanted to Very poor	f) Having somewhere available where you could speak without being overheard, if you wanted to Fairly poor	f) Having somewhere available where you could speak without being overheard, if you wanted to Fairly good	f) Having somewhere available where you could speak without being overheard, if you wanted to Very good	f) Having somewhere available where you could speak without being overheard, if you wanted to Don't know

Please tick one box for each aspect of the service listed below, to show how good or poor you think it is:

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* 5. Q5 Again, including any previous visits to this pharmacy, how would you rate the pharmacist and other staff who work there?

	Very poor	Fairly poor	Fairly good	Very good	Don't know
a) Being polite and taking the time to listen to what you want	a) Being polite and taking the time to listen to what you want Very poor	a) Being polite and taking the time to listen to what you want Fairly poor	a) Being polite and taking the time to listen to what you want Fairly good	a) Being polite and taking the time to listen to what you want Very good	a) Being polite and taking the time to listen to what you want Don't know
b) Answering any queries you may have	b) Answering any queries you may have Very poor	b) Answering any queries you may have Fairly poor	b) Answering any queries you may have Fairly good	b) Answering any queries you may have Very good	b) Answering any queries you may have Don't know
c) The service you received from the pharmacist	c) The service you received from the pharmacist Very poor	c) The service you received from the pharmacist Fairly poor	c) The service you received from the pharmacist Fairly good	c) The service you received from the pharmacist Very good	c) The service you received from the pharmacist Don't know
d) The service you received from the other pharmacy staff	d) The service you received from the other pharmacy staff Very poor	d) The service you received from the other pharmacy staff Fairly poor	d) The service you received from the other pharmacy staff Fairly good	d) The service you received from the other pharmacy staff Very good	d) The service you received from the other pharmacy staff Don't know
e) Providing an efficient service	e) Providing an efficient service Very poor	e) Providing an efficient service Fairly poor	e) Providing an efficient service Fairly good	e) Providing an efficient service Very good	e) Providing an efficient service Don't know
f) The staff overall	f) The staff overall Very poor	f) The staff overall Fairly poor	f) The staff overall Fairly good	f) The staff overall Very good	f) The staff overall Don't know

Please tick one box for each aspect of the service listed below, to show how good or poor you think it is:

Question Title

* 6. Q6 Thinking about all the times you have used this pharmacy, how well do you think it provides each of the following services?

	Not at all well	Not very well	Fairly well	Very well	Never used
a) Providing advice on a current health problem or a longer term health condition	a) Providing advice on a current health problem or a longer term health condition Not at all well	a) Providing advice on a current health problem or a longer term health condition Not very well	a) Providing advice on a current health problem or a longer term health condition Fairly well	a) Providing advice on a current health problem or a longer term health condition Very well	a) Providing advice on a current health problem or a longer term health condition Never used
b) Providing general advice on leading a more healthy lifestyle	b) Providing general advice on leading a more healthy lifestyle Not at all well	b) Providing general advice on leading a more healthy lifestyle Not very well	b) Providing general advice on leading a more healthy lifestyle Fairly well	b) Providing general advice on leading a more healthy lifestyle Very well	b) Providing general advice on leading a more healthy lifestyle Never used
c) Disposing of medicines you no longer need	c) Disposing of medicines you no longer need Not at all well	c) Disposing of medicines you no longer need Not very well	c) Disposing of medicines you no longer need Fairly well	c) Disposing of medicines you no longer need Very well	c) Disposing of medicines you no longer need Never used
d) Providing advice on health services or information available elsewhere	d) Providing advice on health services or information available elsewhere Not at all well	d) Providing advice on health services or information available elsewhere Not very well	d) Providing advice on health services or information available elsewhere Fairly well	d) Providing advice on health services or information available elsewhere Very well	d) Providing advice on health services or information available elsewhere Never used

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* 7. Q7 Have you ever been given advice about any of the following by the pharmacist or pharmacy staff?

	Yes	No
Stop smoking	Stop smoking Yes	Stop smoking No
Healthy eating	Healthy eating Yes	Healthy eating No
Physical exercise	Physical exercise Yes	Physical exercise No

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* 8. Q8 Which of the following best describes how you use this pharmacy?

This is the pharmacy that you choose to visit if possible

This is one of several pharmacies that you use when you need to

This pharmacy was just convenient for you today

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* 9. Please answer yes or no to the following

	Yes	No
Q9 Are you aware the Weldrick Pharmacies have a delivery service?	Q9 Are you aware the Weldrick Pharmacies have a delivery service? Yes	Q9 Are you aware the Weldrick Pharmacies have a delivery service? No
If No, would you have used the service if you had known it existed?	If No, would you have used the service if you had known it existed? Yes	If No, would you have used the service if you had known it existed? No
Q10 Are you aware that Weldrick Pharmacies have a website with health information and an online store?	Q10 Are you aware that Weldrick Pharmacies have a website with health information and an online store? Yes	Q10 Are you aware that Weldrick Pharmacies have a website with health information and an online store? No
If No, would you have used the service if you had known it existed?	If No, would you have used the service if you had known it existed? Yes	If No, would you have used the service if you had known it existed? No
Q11 Are you aware that Weldricks Pharmacies have a Prescription Ordering Service? Not available in some areas.	Q11 Are you aware that Weldricks Pharmacies have a Prescription Ordering Service? Not available in some areas. Yes	Q11 Are you aware that Weldricks Pharmacies have a Prescription Ordering Service? Not available in some areas. No
If No, would you have used the service if you had known it existed?	If No, would you have used the service if you had known it existed? Yes	If No, would you have used the service if you had known it existed? No
Q12 Have you been asked to nominate Weldricks for your electronic prescription?	Q12 Have you been asked to nominate Weldricks for your electronic prescription? Yes	Q12 Have you been asked to nominate Weldricks for your electronic prescription? No
Q13 Would you recommend Weldricks Pharmacies to someone who has a prescription or needs Pharmacy services?	Q13 Would you recommend Weldricks Pharmacies to someone who has a prescription or needs Pharmacy services? Yes	Q13 Would you recommend Weldricks Pharmacies to someone who has a prescription or needs Pharmacy services? No
Q14 Are you aware of the fact that Weldricks Pharmacy is a local, Independently run family business?	Q14 Are you aware of the fact that Weldricks Pharmacy is a local, Independently run family business? Yes	Q14 Are you aware of the fact that Weldricks Pharmacy is a local, Independently run family business? No

These last few questions are just to help us categorise your answers

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* 10. Q15 How old are you?

16-19

20-24

25-34

35-44

45-54

55-64

65+

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* 11. Q16 Are you...

Male

Female

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* 12. Q17 Which of the following apply to you?

You have, or care for, children under 16

You are a carer for someone with a longstanding illness or infirmity

Neither

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* 13. Q18 Finally, taking everything into account -the staff, the shop and the pharmacy- how would you rate the pharmacy where this questionnaire?

Poor

Fair

Good

Very Good

Excellent

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* 14. Q19 If you have any comments about how the service from this pharmacy could be improved, please write them in here:

Question Title

* 15. Which store did you visit

Other (please specify)

	Tick box
Armthorpe The Parade (13 THE PARADE, CHURCH STREET, ARMTHORPE. DN3 3AG) 150	Armthorpe The Parade (13 THE PARADE, CHURCH STREET, ARMTHORPE. DN3 3AG) 150 Tick box
Armthorpe White House Farm 1(WHITE HOUSE FARM MEDICAL CENTRE, CHURCH ST, ARMTHORPE DN3 3AH) 150	Armthorpe White House Farm 1(WHITE HOUSE FARM MEDICAL CENTRE, CHURCH ST, ARMTHORPE DN3 3AH) 150 Tick box
Barnburgh (4 HIGH STREET, BARNBURGH, DONCASTER DN5 7EP) 100	Barnburgh (4 HIGH STREET, BARNBURGH, DONCASTER DN5 7EP) 100 Tick box
Barnby Dun (MARLOWE ROAD, BARNBY DUN, DONCASTER DN3 1AX) 100	Barnby Dun (MARLOWE ROAD, BARNBY DUN, DONCASTER DN3 1AX) 100 Tick box
Bawtry (36 HIGH STREET, BAWTRY . DN10 6JE) 125	Bawtry (36 HIGH STREET, BAWTRY . DN10 6JE) 125 Tick box
Beckett Rd (61- 63 BECKETT ROAD, WHEATLEY. DN2 4AD) 100	Beckett Rd (61- 63 BECKETT ROAD, WHEATLEY. DN2 4AD) 100 Tick box
Bolton (ST ANDREWS SQUARE, BOLTON ON DEARNE. S63 8BA) 150	Bolton (ST ANDREWS SQUARE, BOLTON ON DEARNE. S63 8BA) 150 Tick box
Brinsworth (27 BRINSWORTH LANE, ROTHERHAM. S60 5BS) 150	Brinsworth (27 BRINSWORTH LANE, ROTHERHAM. S60 5BS) 150 Tick box
Cantley Everingham Rd (8 EVERINGHAM ROAD, CANTLEY. DN4 6JG) 125	Cantley Everingham Rd (8 EVERINGHAM ROAD, CANTLEY. DN4 6JG) 125 Tick box
Cantley Goodison Boulevard (THE BURNS PRACTICE, GOODISON BOULEVARD, CANTLEY. DN4 6NJ)150	Cantley Goodison Boulevard (THE BURNS PRACTICE, GOODISON BOULEVARD, CANTLEY. DN4 6NJ)150 Tick box
Cantley St Wilfrids Court (ST WILFRIDS COURT, CANTLEY. DN4 6ED) 100	Cantley St Wilfrids Court (ST WILFRIDS COURT, CANTLEY. DN4 6ED) 100 Tick box
Carcroft (14 HIGH STREET, CARCROFT, DONCASTER. DN6 8DP) 100	Carcroft (14 HIGH STREET, CARCROFT, DONCASTER. DN6 8DP) 100 Tick box
Catcliffe (26 MAIN STREET, CATCLIFFE, ROTHERHAM. S60 5SR) 100	Catcliffe (26 MAIN STREET, CATCLIFFE, ROTHERHAM. S60 5SR) 100 Tick box
Conisbrough Church St (44 CHURCH STREET, CONISBROUGH. DN12 3HR) 100	Conisbrough Church St (44 CHURCH STREET, CONISBROUGH. DN12 3HR) 100 Tick box
Conisbrough Gardens Lane (STONECASTLE CTR., GARDENS LN, CONISBROUGH. DN12 3JW) 150	Conisbrough Gardens Lane (STONECASTLE CTR., GARDENS LN, CONISBROUGH. DN12 3JW) 150 Tick box
Crowle (MARKET PLACE, CROWLE, SCUNTHORPE DN17 4LB) 125	Crowle (MARKET PLACE, CROWLE, SCUNTHORPE DN17 4LB) 125 Tick box
Darnall Main Rd (171 MAIN ROAD, DARNALL, SHEFFIELD. S9 5HP) 125	Darnall Main Rd (171 MAIN ROAD, DARNALL, SHEFFIELD. S9 5HP) 125 Tick box
Darnall PCC (DARNALL PRIMARY CARE CENTRE, MAIN ROAD, DARNALL, SHEFF S9 4QH) 150	Darnall PCC (DARNALL PRIMARY CARE CENTRE, MAIN ROAD, DARNALL, SHEFF S9 4QH) 150 Tick box
Denaby (DENABY SPRINGWELL CTR, CHURCH RD, DENABY MAIN, DONC DN12 4AB) 150	Denaby (DENABY SPRINGWELL CTR, CHURCH RD, DENABY MAIN, DONC DN12 4AB) 150 Tick box
Dunscroft (THE ABBEY SHOPPING CENTRE, STATION ROAD, DUNSCROFT, DONC DN7 4JS) 100	Dunscroft (THE ABBEY SHOPPING CENTRE, STATION ROAD, DUNSCROFT, DONC DN7 4JS) 100 Tick box
East Laith Gate (40-42 EAST LAITH GATE. DN1 1HZ) 150	East Laith Gate (40-42 EAST LAITH GATE. DN1 1HZ) 150 Tick box
Edenthorpe (122 THORNE ROAD, EDENTHORPE. DN3 2JA) 100	Edenthorpe (122 THORNE ROAD, EDENTHORPE. DN3 2JA) 100 Tick box
Edlington Lane (5-5a YORK BUILDINGS, EDLINGTON LANE, DONCASTER DN12 1BU) 125	Edlington Lane (5-5a YORK BUILDINGS, EDLINGTON LANE, DONCASTER DN12 1BU) 125 Tick box
Edlington Martinwells Centre (THE MARTINWELLS CENTRE, THOMPSON AVENUE, EDLINGTON DN12 1JD) 150	Edlington Martinwells Centre (THE MARTINWELLS CENTRE, THOMPSON AVENUE, EDLINGTON DN12 1JD) 150 Tick box
Epworth (5 HURCH STREET, EPWORTH, N LINCOLNSHIRE DN9 1ER) 150	Epworth (5 HURCH STREET, EPWORTH, N LINCOLNSHIRE DN9 1ER) 150 Tick box
Goldthorpe Barnsley Rd (26-28 BARNSLEY ROAD, GOLDTHORPE S63 9NF) 125	Goldthorpe Barnsley Rd (26-28 BARNSLEY ROAD, GOLDTHORPE S63 9NF) 125 Tick box
Goldthorpe Centre (THE GOLDTHORPE CENTRE, GOLDTHORPE GREEN, GOLD. S63 9EH) 150	Goldthorpe Centre (THE GOLDTHORPE CENTRE, GOLDTHORPE GREEN, GOLD. S63 9EH) 150 Tick box
Hallgate (28/29 HALLGATE, DONCASTER DN1 3NL) 100	Hallgate (28/29 HALLGATE, DONCASTER DN1 3NL) 100 Tick box
Harworth (67 SCROOBY ROAD, HARWORTH, DONCASTER DN11 8JN) 75	Harworth (67 SCROOBY ROAD, HARWORTH, DONCASTER DN11 8JN) 75 Tick box
Hatfield (THE HEATHFIELD CENTRE, ASH HILL ROAD, HATFIELD. DN7 6JH) 150	Hatfield (THE HEATHFIELD CENTRE, ASH HILL ROAD, HATFIELD. DN7 6JH) 150 Tick box
Haxey (30 CHURCH STREET, HAXEY, DONCASTER DN9 2HY) 150	Haxey (30 CHURCH STREET, HAXEY, DONCASTER DN9 2HY) 150 Tick box
Intake (81 SANDRINGHAM ROAD, INTAKE DN2 5JA) 100	Intake (81 SANDRINGHAM ROAD, INTAKE DN2 5JA) 100 Tick box
Kirk Sandall (54 BRECKS LANE, KIRK SANDALL, DONCASTER DN3 1JR) 100	Kirk Sandall (54 BRECKS LANE, KIRK SANDALL, DONCASTER DN3 1JR) 100 Tick box
Leedale Internet (LEEDALE HOUSE, RAILWAY COURT, DONCASTER DN4 5FB) 150	Leedale Internet (LEEDALE HOUSE, RAILWAY COURT, DONCASTER DN4 5FB) 150 Tick box
Lodgemoor (66 ROCHESTER ROAD, LODGE MOOR, SHEFFIELD S10 4JQ) 125	Lodgemoor (66 ROCHESTER ROAD, LODGE MOOR, SHEFFIELD S10 4JQ) 125 Tick box
Maltby High Street (94A HIGH STREET, MALTBY. S66 7BN) 125	Maltby High Street (94A HIGH STREET, MALTBY. S66 7BN) 125 Tick box
Maltby Laburnum Parade (3 LABURNUM PARADE, MALTBY, ROTHERHAM S66 8DP) 75	Maltby Laburnum Parade (3 LABURNUM PARADE, MALTBY, ROTHERHAM S66 8DP) 75 Tick box
Maltby Services Centre (MALTBY SERVICES CENTRE, BRAITHWELL ROAD, MALTBY. S66 8JE) 150	Maltby Services Centre (MALTBY SERVICES CENTRE, BRAITHWELL ROAD, MALTBY. S66 8JE) 150 Tick box
Moorends (THE ORCHARD CENTRE, MARSHLANDS ROAD, MOORENDS. DN8 4SB) 150	Moorends (THE ORCHARD CENTRE, MARSHLANDS ROAD, MOORENDS. DN8 4SB) 150 Tick box
Owlthorpe (1 MOORTHORPE BANK, OWLTHORPE, SHEFFIELD S20 6PD) 125	Owlthorpe (1 MOORTHORPE BANK, OWLTHORPE, SHEFFIELD S20 6PD) 125 Tick box
Rossington (35 GRANGE LANE, ROSSINGTON. DN11 0LW) 150	Rossington (35 GRANGE LANE, ROSSINGTON. DN11 0LW) 150 Tick box
Royston High Street (48A HIGH STREET, ROYSTON. S71 4RF) 125	Royston High Street (48A HIGH STREET, ROYSTON. S71 4RF) 125 Tick box
Royston Midland Road (65C MIDLAND ROAD, ROYSTON. S71 4QW) 150	Royston Midland Road (65C MIDLAND ROAD, ROYSTON. S71 4QW) 150 Tick box
Scawthorpe (100 AMERSALL ROAD, SCAWTHORPE, DONCASTER. DN5 9PH) 150	Scawthorpe (100 AMERSALL ROAD, SCAWTHORPE, DONCASTER. DN5 9PH) 150 Tick box
SCUNTHORPE IRONSTONE CTR (WEST STREET, SCUNTHORPE. DN15 6HX) 150	SCUNTHORPE IRONSTONE CTR (WEST STREET, SCUNTHORPE. DN15 6HX) 150 Tick box
Scunthorpe Frodingham Road, ( WEST STREET, SCUNTHORPE, N Lincs DN15 7NJ) 150	Scunthorpe Frodingham Road, ( WEST STREET, SCUNTHORPE, N Lincs DN15 7NJ) 150 Tick box
Skellow (221 (Unit 4) SKELLOW ROAD, SKELLOW, DONCASTER. DN6 8JH) 75	Skellow (221 (Unit 4) SKELLOW ROAD, SKELLOW, DONCASTER. DN6 8JH) 75 Tick box
Sothall (26 ECKINGTON ROAD, SOTHALL, SHEFFIELD S20 1HQ) 150	Sothall (26 ECKINGTON ROAD, SOTHALL, SHEFFIELD S20 1HQ) 150 Tick box
Sprotbrough Road (235 SPROTBROUGH ROAD, DN5 8BP) 125	Sprotbrough Road (235 SPROTBROUGH ROAD, DN5 8BP) 125 Tick box
Stainforth Field Rd (FIELD ROAD, STAINFORTH. DN7 5AF) 150	Stainforth Field Rd (FIELD ROAD, STAINFORTH. DN7 5AF) 150 Tick box
Stainforth Station Rd (STATION ROAD, STAINFORTH. DN7 5NS) 75	Stainforth Station Rd (STATION ROAD, STAINFORTH. DN7 5NS) 75 Tick box
Swallownest (31/33 HIGH STREET, SWALLOWNEST, SHEFFIELD S26 4TT) 150	Swallownest (31/33 HIGH STREET, SWALLOWNEST, SHEFFIELD S26 4TT) 150 Tick box
Swinton Church Street (1A – 3A CHURCH STREET, SWINTON, S64 8QA) 125	Swinton Church Street (1A – 3A CHURCH STREET, SWINTON, S64 8QA) 125 Tick box
Swinton Crown St (17 CROWN STREET, SWINTON. S64 8NB) 125	Swinton Crown St (17 CROWN STREET, SWINTON. S64 8NB) 125 Tick box
The Flying Scotsman Centre (ST SEPULCHRE GATE WEST, DONCASTER DN1 3AP) 125	The Flying Scotsman Centre (ST SEPULCHRE GATE WEST, DONCASTER DN1 3AP) 125 Tick box
THORNE FIELDSIDE (14 FIELDSIDE, THORNE. DN8 4BQ) 125	THORNE FIELDSIDE (14 FIELDSIDE, THORNE. DN8 4BQ) 125 Tick box
THORNE FINKLE STREET (2 – 4 FINKLE STREET, THORNE. DN8 5DE) 75	THORNE FINKLE STREET (2 – 4 FINKLE STREET, THORNE. DN8 5DE) 75 Tick box
Thurnscoe Holly Bush Drive (THE THURNSCOE CENTRE, HOLLY BUSH DRIVE, THURNSCOE S63 0LT) 150	Thurnscoe Holly Bush Drive (THE THURNSCOE CENTRE, HOLLY BUSH DRIVE, THURNSCOE S63 0LT) 150 Tick box
Thurnscoe Welfare Rd (WELFARE ROAD, THURNSCOE. S63 0JZ) 150	Thurnscoe Welfare Rd (WELFARE ROAD, THURNSCOE. S63 0JZ) 150 Tick box
Wheatley (296 THORNE ROAD, WHEATLEY HILLS, DONCASTER DN2 5AJ) 100	Wheatley (296 THORNE ROAD, WHEATLEY HILLS, DONCASTER DN2 5AJ) 100 Tick box
Woodlands Princess St (2 PRINCESS STREET, WOODLANDS, DONCASTER DN6 7LX) 150	Woodlands Princess St (2 PRINCESS STREET, WOODLANDS, DONCASTER DN6 7LX) 150 Tick box
Woodlands Woodside View (WOODSIDE VIEW, THE CRESCENT, WOODLANDS, DONCASTER DN6 7JR) 125	Woodlands Woodside View (WOODSIDE VIEW, THE CRESCENT, WOODLANDS, DONCASTER DN6 7JR) 125 Tick box
Store 1	Store 1 Tick box
Store 2	Store 2 Tick box
Store 3	Store 3 Tick box
Store 4	Store 4 Tick box
Store 5	Store 5 Tick box

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* 1. Q1. Why did you visit this pharmacy today?To collect a prescription for:

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* 2. Q2 If you collected a prescription today, were you able to collect it straight away, did you have to wait in the pharmacy or did you come back later to collect it?

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* 3. Q3 How satisfied were you with the time it took to provide your prescription and/or any other NHS services you required?

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* 4. Q4 Thinking about previous visits as well as today's, how would you rate the pharmacy on the following factors?

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* 5. Q5 Again, including any previous visits to this pharmacy, how would you rate the pharmacist and other staff who work there?

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* 6. Q6 Thinking about all the times you have used this pharmacy, how well do you think it provides each of the following services?

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* 7. Q7 Have you ever been given advice about any of the following by the pharmacist or pharmacy staff?

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* 8. Q8 Which of the following best describes how you use this pharmacy?

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* 9. Please answer yes or no to the following

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* 10. Q15 How old are you?

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* 11. Q16 Are you...

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* 12. Q17 Which of the following apply to you?

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* 13. Q18 Finally, taking everything into account -the staff, the shop and the pharmacy- how would you rate the pharmacy where this questionnaire?

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* 14. Q19 If you have any comments about how the service from this pharmacy could be improved, please write them in here:

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* 15. Which store did you visit

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* 16. Sign with your initials to complete

* 1. Q1. Why did you visit this pharmacy today?
To collect a prescription for: