The InfuCare Rx Partner Satisfaction SurveyDo not include any patient identifying information in your responses.

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* 1. Respondent Type:

Prescriber (Physician, Practitioner, or Physician Assistant)

Other (please specify)

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* 2. The name of the facility or practice you represent:

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* 3. Care Planning: How satisfied are you with the process and ease of starting your patient on service with InfuCare Rx?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 5. Quality: How satisfied are you with the safety, quality of care, products, and information delivered by InfuCare Rx?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 6. Staff Responsiveness: How satisfied are you with the courteous and timely responsiveness of our staff to your inquiries?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 7. Staff Knowledge: How would you rate our staff's knowledge regarding services we provide?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 8. Pharmacy Services: How satisfied are you with the clinical pharmacy services provided?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 9. Nursing Services: How satisfied are you with the nursing care provided to your patients?

1 - Very satisfied

2 - Somewhat satisfied

3 - Neutral or N/A

4 - Somewhat dissatisfied

5 - Very dissatisfied

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* 10. Communication: How would you rate the politeness, helpfulness, and ease of contacting staff members at InfuCare Rx?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 11. Complaint Resolution: How satisfied are you with the timely and comprehensive manner for which your concerns were investigated and resolved?

5 - Very satisfied

4 - Somewhat satisfied

3 - Neutral or N/A

2 - Somewhat dissatisfied

1 - Very dissatisfied

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* 12. Satisfaction: How likely are you to recommend InfuCare Rx to others?

4 - Very likely

3 - Somewhat likely

2 - Neutral or N/A

1 - Not likely

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* 13. Do you have any other comments, questions, or suggestions regarding how we can improve our service to you?

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* 14. Feedback is important to us and your input will help us better serve you. Are you interested in further communication regarding your survey responses?

Yes

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* 15. Please provide your name and practice information.

Prescriber Name

Contact Name