Pharmacy Patient Satisfaction Survey

Providing excellent customer service is a top priority for Price Chopper/Market 32 Pharmacy. Thank you for taking the time to participate in this survey.

Question Title

* 1. Please rate your degree of satisfaction on a scale of 1 (completely dissatisfied) to 5 (completely satisfied) or select N/A if not applicable.

  Completely Dissatisfied Somewhat Dissatisfied Neutral Somewhat Satisfied Completely Satisfied N/A
Customer service provided by the pharmacist
Customer service provided by Pharmacy Teammate
Product education/training provided
Quality of product/service received
All questions/concerns were addressed

Question Title

* 2. Please choose Yes or No

  Yes No N/A
Your name and date of birth were confirmed by a Teammate at the pharmacy checkout.
A Teammate asked if you had any questions for the pharmacist or if you would like to be counseled on your prescriptions.
A Teammate reviewed your co-payments and final charges with you to make sure they were correct at the pharmacy checkout.
You were provided an attestation form to sign, where applicable.

Question Title

* 3. Please add any comments about your PriceChopper/Market32 Pharmacy experience.

Question Title

* 4. Enter Date of Service

Date / Time

Question Title

* 5. Please enter the store number or the city of the Price Chopper/Market32 Pharmacy you visited. The store number is the 3 digit number after the prescription number on your pharmacy receipt or prescription label. (ex. Rx# 1234567- 112)

Question Title

* 6. Please select all that apply.
What pharmacy service were you provided?

Question Title

* 7. Please enter your AdvantEdge card number (OPTIONAL)

Question Title

* 8. May we contact you?

T