Inova Pharmacy Survey

We would like to know your honest opinion about what you CURRENTLY think of the services you have received from us. Please read each item below and select the response that best matches your opinion about our services.

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
My phone call was answered promptly during normal business hours.	My phone call was answered promptly during normal business hours. Strongly Disagree	My phone call was answered promptly during normal business hours. Disagree	My phone call was answered promptly during normal business hours. Neutral	My phone call was answered promptly during normal business hours. Agree	My phone call was answered promptly during normal business hours. Strongly Agree	My phone call was answered promptly during normal business hours. N/A
I was able to contact the pharmacy after business hours.	I was able to contact the pharmacy after business hours. Strongly Disagree	I was able to contact the pharmacy after business hours. Disagree	I was able to contact the pharmacy after business hours. Neutral	I was able to contact the pharmacy after business hours. Agree	I was able to contact the pharmacy after business hours. Strongly Agree	I was able to contact the pharmacy after business hours. N/A
My prescription was filled in a timely manner.	My prescription was filled in a timely manner. Strongly Disagree	My prescription was filled in a timely manner. Disagree	My prescription was filled in a timely manner. Neutral	My prescription was filled in a timely manner. Agree	My prescription was filled in a timely manner. Strongly Agree	My prescription was filled in a timely manner. N/A
The pharmacy team was respectful, caring, and helpful.	The pharmacy team was respectful, caring, and helpful. Strongly Disagree	The pharmacy team was respectful, caring, and helpful. Disagree	The pharmacy team was respectful, caring, and helpful. Neutral	The pharmacy team was respectful, caring, and helpful. Agree	The pharmacy team was respectful, caring, and helpful. Strongly Agree	The pharmacy team was respectful, caring, and helpful. N/A
I received counseling and/or written information about my prescription upon delivery or at pick up.	I received counseling and/or written information about my prescription upon delivery or at pick up. Strongly Disagree	I received counseling and/or written information about my prescription upon delivery or at pick up. Disagree	I received counseling and/or written information about my prescription upon delivery or at pick up. Neutral	I received counseling and/or written information about my prescription upon delivery or at pick up. Agree	I received counseling and/or written information about my prescription upon delivery or at pick up. Strongly Agree	I received counseling and/or written information about my prescription upon delivery or at pick up. N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

My phone call was answered promptly during normal business hours.

My phone call was answered promptly during normal business hours. Strongly Disagree

My phone call was answered promptly during normal business hours. Disagree

My phone call was answered promptly during normal business hours. Neutral

My phone call was answered promptly during normal business hours. Agree

My phone call was answered promptly during normal business hours. Strongly Agree

My phone call was answered promptly during normal business hours. N/A

I was able to contact the pharmacy after business hours.

I was able to contact the pharmacy after business hours. Strongly Disagree

I was able to contact the pharmacy after business hours. Disagree

I was able to contact the pharmacy after business hours. Neutral

I was able to contact the pharmacy after business hours. Agree

I was able to contact the pharmacy after business hours. Strongly Agree

I was able to contact the pharmacy after business hours. N/A

My prescription was filled in a timely manner.

My prescription was filled in a timely manner. Strongly Disagree

My prescription was filled in a timely manner. Disagree

My prescription was filled in a timely manner. Neutral

My prescription was filled in a timely manner. Agree

My prescription was filled in a timely manner. Strongly Agree

My prescription was filled in a timely manner. N/A

The pharmacy team was respectful, caring, and helpful.

The pharmacy team was respectful, caring, and helpful. Strongly Disagree

The pharmacy team was respectful, caring, and helpful. Disagree

The pharmacy team was respectful, caring, and helpful. Neutral

The pharmacy team was respectful, caring, and helpful. Agree

The pharmacy team was respectful, caring, and helpful. Strongly Agree

The pharmacy team was respectful, caring, and helpful. N/A

I received counseling and/or written information about my prescription upon delivery or at pick up.

I received counseling and/or written information about my prescription upon delivery or at pick up. Strongly Disagree

I received counseling and/or written information about my prescription upon delivery or at pick up. Disagree

I received counseling and/or written information about my prescription upon delivery or at pick up. Neutral

I received counseling and/or written information about my prescription upon delivery or at pick up. Agree

I received counseling and/or written information about my prescription upon delivery or at pick up. Strongly Agree

I received counseling and/or written information about my prescription upon delivery or at pick up. N/A

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
The pharmacy call staff arranged for timely delivery of my medication.	The pharmacy call staff arranged for timely delivery of my medication. Strongly Disagree	The pharmacy call staff arranged for timely delivery of my medication. Disagree	The pharmacy call staff arranged for timely delivery of my medication. Neutral	The pharmacy call staff arranged for timely delivery of my medication. Agree	The pharmacy call staff arranged for timely delivery of my medication. Strongly Agree	The pharmacy call staff arranged for timely delivery of my medication. N/A
The pharmacy liaison who coordinated the shipping was knowledgeable and professional.	The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Strongly Disagree	The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Disagree	The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Neutral	The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Agree	The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Strongly Agree	The pharmacy liaison who coordinated the shipping was knowledgeable and professional. N/A
The clinical pharmacist was knowledgeable and professional.	The clinical pharmacist was knowledgeable and professional. Strongly Disagree	The clinical pharmacist was knowledgeable and professional. Disagree	The clinical pharmacist was knowledgeable and professional. Neutral	The clinical pharmacist was knowledgeable and professional. Agree	The clinical pharmacist was knowledgeable and professional. Strongly Agree	The clinical pharmacist was knowledgeable and professional. N/A
I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance.	I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Strongly Disagree	I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Disagree	I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Neutral	I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Agree	I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Strongly Agree	I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

The pharmacy call staff arranged for timely delivery of my medication.

The pharmacy call staff arranged for timely delivery of my medication. Strongly Disagree

The pharmacy call staff arranged for timely delivery of my medication. Disagree

The pharmacy call staff arranged for timely delivery of my medication. Neutral

The pharmacy call staff arranged for timely delivery of my medication. Agree

The pharmacy call staff arranged for timely delivery of my medication. Strongly Agree

The pharmacy call staff arranged for timely delivery of my medication. N/A

The pharmacy liaison who coordinated the shipping was knowledgeable and professional.

The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Strongly Disagree

The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Disagree

The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Neutral

The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Agree

The pharmacy liaison who coordinated the shipping was knowledgeable and professional. Strongly Agree

The pharmacy liaison who coordinated the shipping was knowledgeable and professional. N/A

The clinical pharmacist was knowledgeable and professional.

The clinical pharmacist was knowledgeable and professional. Strongly Disagree

The clinical pharmacist was knowledgeable and professional. Disagree

The clinical pharmacist was knowledgeable and professional. Neutral

The clinical pharmacist was knowledgeable and professional. Agree

The clinical pharmacist was knowledgeable and professional. Strongly Agree

The clinical pharmacist was knowledgeable and professional. N/A

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance.

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Strongly Disagree

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Disagree

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Neutral

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Agree

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. Strongly Agree

I received the help I needed from the liaison or pharmacy billing specialist in obtaining authorization to fill and financial assistance. N/A

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree	N/A
Any billing/insurance issues or questions were resolved promptly.	Any billing/insurance issues or questions were resolved promptly. Strongly Disagree	Any billing/insurance issues or questions were resolved promptly. Disagree	Any billing/insurance issues or questions were resolved promptly. Neutral	Any billing/insurance issues or questions were resolved promptly. Agree	Any billing/insurance issues or questions were resolved promptly. Strongly Agree	Any billing/insurance issues or questions were resolved promptly. N/A
The pharmacy's website is clear and helpful.	The pharmacy's website is clear and helpful. Strongly Disagree	The pharmacy's website is clear and helpful. Disagree	The pharmacy's website is clear and helpful. Neutral	The pharmacy's website is clear and helpful. Agree	The pharmacy's website is clear and helpful. Strongly Agree	The pharmacy's website is clear and helpful. N/A
This pharmacy's overall service level is great.	This pharmacy's overall service level is great. Strongly Disagree	This pharmacy's overall service level is great. Disagree	This pharmacy's overall service level is great. Neutral	This pharmacy's overall service level is great. Agree	This pharmacy's overall service level is great. Strongly Agree	This pharmacy's overall service level is great. N/A
It is easy to fill a prescription at this pharmacy.	It is easy to fill a prescription at this pharmacy. Strongly Disagree	It is easy to fill a prescription at this pharmacy. Disagree	It is easy to fill a prescription at this pharmacy. Neutral	It is easy to fill a prescription at this pharmacy. Agree	It is easy to fill a prescription at this pharmacy. Strongly Agree	It is easy to fill a prescription at this pharmacy. N/A
I would recommend this pharmacy to my friends and family.	I would recommend this pharmacy to my friends and family. Strongly Disagree	I would recommend this pharmacy to my friends and family. Disagree	I would recommend this pharmacy to my friends and family. Neutral	I would recommend this pharmacy to my friends and family. Agree	I would recommend this pharmacy to my friends and family. Strongly Agree	I would recommend this pharmacy to my friends and family. N/A

Strongly Disagree

Disagree

Neutral

Agree

Strongly Agree

N/A

Any billing/insurance issues or questions were resolved promptly.

Any billing/insurance issues or questions were resolved promptly. Strongly Disagree

Any billing/insurance issues or questions were resolved promptly. Disagree

Any billing/insurance issues or questions were resolved promptly. Neutral

Any billing/insurance issues or questions were resolved promptly. Agree

Any billing/insurance issues or questions were resolved promptly. Strongly Agree

Any billing/insurance issues or questions were resolved promptly. N/A

The pharmacy's website is clear and helpful.

The pharmacy's website is clear and helpful. Strongly Disagree

The pharmacy's website is clear and helpful. Disagree

The pharmacy's website is clear and helpful. Neutral

The pharmacy's website is clear and helpful. Agree

The pharmacy's website is clear and helpful. Strongly Agree

The pharmacy's website is clear and helpful. N/A

This pharmacy's overall service level is great.

This pharmacy's overall service level is great. Strongly Disagree

This pharmacy's overall service level is great. Disagree

This pharmacy's overall service level is great. Neutral

This pharmacy's overall service level is great. Agree

This pharmacy's overall service level is great. Strongly Agree

This pharmacy's overall service level is great. N/A

It is easy to fill a prescription at this pharmacy.

It is easy to fill a prescription at this pharmacy. Strongly Disagree

It is easy to fill a prescription at this pharmacy. Disagree

It is easy to fill a prescription at this pharmacy. Neutral

It is easy to fill a prescription at this pharmacy. Agree

It is easy to fill a prescription at this pharmacy. Strongly Agree

It is easy to fill a prescription at this pharmacy. N/A

I would recommend this pharmacy to my friends and family.

I would recommend this pharmacy to my friends and family. Strongly Disagree

I would recommend this pharmacy to my friends and family. Disagree

I would recommend this pharmacy to my friends and family. Neutral

I would recommend this pharmacy to my friends and family. Agree

I would recommend this pharmacy to my friends and family. Strongly Agree

I would recommend this pharmacy to my friends and family. N/A

Inova Pharmacy Survey

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* 1. Check the pharmacy location where you received services:

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* 2. Please rate your interactions with our pharmacy staff:

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* 3. Please rate your interactions with the pharmacy call center staff for specialty medication delivery (if applicable):

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* 4. Please rate the overall experience when filling your prescription:

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* 5. Additional comments or recommendations about your experience, or if you'd like to recognize someone please include their name and reason.

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* 6. For a call back, please include your name and number below and we will follow up with you.