* 1. How did you order your medication? Select all that apply

* 2. How would you rate your overall experience with LDI Pharmacy?

3. Using the scale above, please rate the following qualities based on how you ordered your prescriptions.

* Mail in:

  1 2 3 4 5 N/A
The time required from order placement to receiving your order.

* Automated Phone System:

  1 2 3 4 5 N/A
The ease of ordering your prescriptions.

* Online at LDIRx.com:

  1 2 3 4 5 N/A
The ease of ordering your prescriptions.
The information provided on the website.
Creating your online account.

* Automatic Refill Program:

  1 2 3 4 5 N/A
Enrolling in the program online.
Accuracy and timeliness of receiving your prescriptions.

* Customer Service Representative:

  1 2 3 4 5 N/A
The speed your phone call was answered.
The friendliness of the representative.
The professionalism of the representative.

* 4. How long did it take to receive your prescription order?

* 5. How long have you been using LDI Pharmacy?

* 6. Please provide any comments and/or suggestions

* Please give your name and phone number if you want to speak with LDI regarding your experience.

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