Patients
Providers
Contact
0
GET VERIFIED
Patient Survey
Your opinion is extremely important and we will use it to improve the quality of our care.
Please take a few minutes to fill out this survey.
Items marked with * require a response.
The staff explained how they obtained your medication order
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff explained financial responsibility, insurance coverage , insurance benefit and cost
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff included the Notice of Privacy information
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff explained your care plan
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff discussed your shipping and how to order refills
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff was courteous over the phone
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The medication was delivered in time
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff was easy to reach if you called with a question
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The response you received when you called for assistance on weekends or after hours was satisfactory
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff assisted you with complaints or problems
*
Strongly Agree
Agree
Neutral
Disagree
N/A
Adequate information about how to store your medication was supplied
*
Strongly Agree
Agree
Neutral
Disagree
N/A
Adequate information about possible side effects was supplied
*
Strongly Agree
Agree
Neutral
Disagree
N/A
Adequate information about emergency preparedness was supplied
*
Strongly Agree
Agree
Neutral
Disagree
N/A
Adequate information about how to dispose medications and sharps was supplied
*
Strongly Agree
Agree
Neutral
Disagree
N/A
The staff was respectful and courteous in your home
*
Strongly Agree
Agree
Neutral
Disagree
N/A
You felt comfortable administrating the medication
*
Strongly Agree
Agree
Neutral
Disagree
N/A
You are satisfied with the overall quality of information and care you are receiving
*
Strongly Agree
Agree
Neutral
Disagree
N/A
You are likely to recommend our services
*
Strongly Agree
Agree
Neutral
Disagree
N/A
Please share any additional comments, concerns or suggestions to help us improve care and patient safety.
Is there a particular staff member you would like to mention? Why?
Name
First
Last
Phone
Email
CAPTCHA
GET VERIFIED
0