Patient Satisfaction Survey Question Title * 1. Overall, how satisfied are you with the ease of filling your prescription with us? Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Question Title * 2. Overall, how satisfied are you with the delivery/pick-up of your prescription? Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Question Title * 3. Overall, how satisfied are you with your interaction with a TFP team member? Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Question Title * 4. If you received information regarding your prescription(s) from the pharmacist, how satisfied were you? Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Does not apply Question Title * 5. How satisfied are you that your phone calls were answered promptly? Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Does not apply Question Title * 6. How satisfied are you with the assistance you received regarding the coverage of your prescription? Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Does not apply Question Title * 7. Compared to other pharmacies that you have used, please rate your level of satisfaction with TFP. Extremely Satisfied Satisfied Neutral/Not Sure Dissatisfied Very Dissatisfied Question Title * 8. Will you recommend TFP to your friends and family? Yes No Question Title * 9. Additional Comments: (Response is not HIPAA protected) Question Title * 10. Contact Information (Optional) Name Done
