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Belmar Pharmacy (KS) Customer Satisfaction Survey
Your opinion matters!
Thank you for taking the time to complete this survey. Your opinion is important to help us make improvements to the overall Belmar experience.
1.
Please tell us about yourself (optional).
Name
Phone Number
Email
*
2.
Were you satisfied with your experience using Belmar Pharmacy?
(Required.)
Very satisfied
Satisfied
Not Satisfied
N/A
Your satisfaction is important to us and we welcome open feedback (positive or negative) so we can improve your Belmar experience. We encourage you to provide further detail below. (optional)
*
3.
Was the staff you interacted with friendly and helpful?
(Required.)
Yes
No
N/A
Please tell us a bit more about why you chose the answer above. (optional)
*
4.
Was the staff you interacted with knowledgeable about your prescription(s)?
(Required.)
Yes
No
N/A
Please tell us a bit more about why you chose the answer above. (optional)
*
5.
Prescription Packaging
(Required.)
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
I can easily read the drug name and strength on the prescription label.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
I understand how to use my prescription.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
My prescription comes in a professional looking bottle/device.
Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Additional feedback (optional)
*
6.
Would you recommend Belmar Pharmacy to another patient?
(Required.)
Yes
No
Please tell us a bit more about why you chose the answer above. (optional)
7.
What would have improved your experience using Belmar Pharmacy?
8.
Is there anything else you would like us to know?
