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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.
1.
Respondent Type:
Patient
Caregiver
Other (please specify)
2.
Insurance Type:
Medicare
Medicaid
Aetna
Prime Therapeutics
CIGNA
United Healthcare
Anthem
Humana
BCBS
Other (please specify)
3.
Pharmacy Servicing Location:
CA
FL
LA
MD
NJ
PA
TX
Unknown
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
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
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
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
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
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
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
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
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
