The InfuCare Rx Patient Satisfaction Survey
Do not include any patient identifying information in your responses.

Please do not include any patient identifying information in your responses.

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* 1. Respondent Type:

Patient

Caregiver

Other (please specify)

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* 2. Insurance Type:

Medicare

Medicaid

Aetna

Prime Therapeutics

CIGNA

United Healthcare

Anthem

Humana

BCBS

Other (please specify)

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* 3. Pharmacy Servicing Location:

Unknown

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* 4. Care planning: When you started service with InfuCare Rx, how satisfied were you with the process, including understanding your care plan and your financial responsibility?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 5. Delivery: How satisfied are you with the accuracy and timeliness of the delivery of your products?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 6. Quality: How satisfied are you with the quality of care, supplies, and equipment provided by InfuCare Rx?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 7. Outcomes: How would you rate the effectiveness of your care plan provided by InfuCare Rx to treat your condition?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 8. Pharmacy: How would you rate the clinical pharmacy services provided by InfuCare Rx?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 9. Nursing: How satisfied are you with the nursing services provided?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 10. Education: How would you rate the information/education you received regarding our services?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 11. Communication: How satisfied are you with the level of politeness, helpfulness, and ease of contacting our employees?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

Question Title

* 12. Satisfaction: How would you feel referring others to our services?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied