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* 1. What is Your Contact Information (all information will be kept confidential)?

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* 2. How many pharmacies do you own?

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* 3. How many employees do you currently have?

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* 4. What is the population of your community?

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* 5. What do you currently pay your pharmacists?

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* 6. What do you current pay your technicians?

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* 7. What do you currently pay your clerks?

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* 8. Do your currently offer benefits to your employees?

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* 9. If Yes to Question 5, What benefits do you currently offer?

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* 10. If you offer a retirement plan, what kind do you have?

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* 11. If you offer paid time off, please describe your program?

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* 12. If you offer health insurance, who do you cover?

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* 13. If you offer health insurance, what amount do you cover for the employee?

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* 14. If you offer health insurance, what amount do you cover for the spouse?

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* 15. If you offer health insurance, what amount do you cover for the the children?

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* 16. Do you have an annual budget for your employee benefits?

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* 17. If you have a budget, what percentage of sales does it represent?

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* 18. What dollar amount do you currently spend on employee benefits?

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* 19. How many days do you take off during the year?

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* 20. Do you feel you have enough time for the most important things in your life?

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* 21. How would you rate your work stress levels currently?

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* 22. Does your stress at work affect your personal life?

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* 23. How would you rate your current quality of sleep?

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* 24. How would you rate your current level of nutrition?

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* 25. How often do you work out every week?

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* 26. How would you rate your current quality of life?

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