Give Us Your Feedback! Thank you for taking the time to provide us feedback! In a constant effort to provide compassionate service, your answers help us improve your experience with Akina. Question Title Please provide us with your contact information if you would like us to respond to you directly regarding your feedback. This information is kept private and confidential. Name Email Address Phone Number Question Title I am a I am a patient I am a doctor I work at a medical practice I work at a hospital I work for another pharmacy I am a student or researcher I work in a related field Question Title Please tell us why you are reaching out. Praise Make a request or suggestion Bad experience Product quality Other (please specify) Question Title How likely is it that you would recommend Akina Pharmacy to a friend or colleague? Not at all likely Extremely likely 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 Question Title How would you rate the courtesy and helpfulness of the call center staff? Poor Fair Good Very Good Excellent Poor Fair Good Very Good Excellent Question Title How would you rate the timeliness in receiving your order? Poor Fair Good Very Good Excellent Poor Fair Good Very Good Excellent Question Title What is your overall satisfaction with the product you have received? Poor Fair Good Very Good Excellent Poor Fair Good Very Good Excellent Question Title Tell us what's on your mind: Question Title Would you like an Akina team member to contact you? Yes No Done