Specialty Patient Satisfaction Survey

Thank you for being a valued client of Total Health Care Pharmacy. We request that you complete the following survey to assist us in the improvement of treatment, care and services.

Q1	Please answer the following questions with Strongly agree meaning you were totally satisfied with service to Strongly disagree meaning you were completely unsatisfied. If a question/service does not apply to your situation please choose N/A.
Q1		Strongly Disagree	Somewhat Disagree	Neutral	Somewhat Agree	Strongly Agree	N/A
	My initial contact with Total Health Care Specialty Pharmacy Staff was positive.	My initial contact with Total Health Care Specialty Pharmacy Staff was positive. Strongly Disagree	My initial contact with Total Health Care Specialty Pharmacy Staff was positive. Somewhat Disagree	My initial contact with Total Health Care Specialty Pharmacy Staff was positive. Neutral	My initial contact with Total Health Care Specialty Pharmacy Staff was positive. Somewhat Agree	My initial contact with Total Health Care Specialty Pharmacy Staff was positive. Strongly Agree	My initial contact with Total Health Care Specialty Pharmacy Staff was positive. N/A

	The staff was courteous and professional.	The staff was courteous and professional. Strongly Disagree	The staff was courteous and professional. Somewhat Disagree	The staff was courteous and professional. Neutral	The staff was courteous and professional. Somewhat Agree	The staff was courteous and professional. Strongly Agree	The staff was courteous and professional. N/A

	The staff was knowledgeable regarding my disease state and medication(s).	The staff was knowledgeable regarding my disease state and medication(s). Strongly Disagree	The staff was knowledgeable regarding my disease state and medication(s). Somewhat Disagree	The staff was knowledgeable regarding my disease state and medication(s). Neutral	The staff was knowledgeable regarding my disease state and medication(s). Somewhat Agree	The staff was knowledgeable regarding my disease state and medication(s). Strongly Agree	The staff was knowledgeable regarding my disease state and medication(s). N/A

	My medications were filled accurately.	My medications were filled accurately. Strongly Disagree	My medications were filled accurately. Somewhat Disagree	My medications were filled accurately. Neutral	My medications were filled accurately. Somewhat Agree	My medications were filled accurately. Strongly Agree	My medications were filled accurately. N/A

	My medications were filled in a timely manner.	My medications were filled in a timely manner. Strongly Disagree	My medications were filled in a timely manner. Somewhat Disagree	My medications were filled in a timely manner. Neutral	My medications were filled in a timely manner. Somewhat Agree	My medications were filled in a timely manner. Strongly Agree	My medications were filled in a timely manner. N/A

	I was clearly educated regarding medication safety, storage, administration and disposal.	I was clearly educated regarding medication safety, storage, administration and disposal. Strongly Disagree	I was clearly educated regarding medication safety, storage, administration and disposal. Somewhat Disagree	I was clearly educated regarding medication safety, storage, administration and disposal. Neutral	I was clearly educated regarding medication safety, storage, administration and disposal. Somewhat Agree	I was clearly educated regarding medication safety, storage, administration and disposal. Strongly Agree	I was clearly educated regarding medication safety, storage, administration and disposal. N/A

	The welcome package material was clear and useful.	The welcome package material was clear and useful. Strongly Disagree	The welcome package material was clear and useful. Somewhat Disagree	The welcome package material was clear and useful. Neutral	The welcome package material was clear and useful. Somewhat Agree	The welcome package material was clear and useful. Strongly Agree	The welcome package material was clear and useful. N/A

	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction.	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction. Strongly Disagree	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction. Somewhat Disagree	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction. Neutral	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction. Somewhat Agree	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction. Strongly Agree	The staff was able to answer all questions concerning my medication(s) and/or therapy to my satisfaction. N/A

	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs.	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs. Strongly Disagree	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs. Somewhat Disagree	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs. Neutral	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs. Somewhat Agree	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs. Strongly Agree	The pharmacy worked with my physician and insurance to provide coordination of care that met my needs. N/A

	I understand my individual plan of care/treatment plan.	I understand my individual plan of care/treatment plan. Strongly Disagree	I understand my individual plan of care/treatment plan. Somewhat Disagree	I understand my individual plan of care/treatment plan. Neutral	I understand my individual plan of care/treatment plan. Somewhat Agree	I understand my individual plan of care/treatment plan. Strongly Agree	I understand my individual plan of care/treatment plan. N/A

	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations.	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations. Strongly Disagree	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations. Somewhat Disagree	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations. Neutral	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations. Somewhat Agree	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations. Strongly Agree	My overall experience with Total Health Care Specialty Pharmacy has exceeded my expectations. N/A

Q2	Any comments or suggestions?

Thanks for your time.
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Specialty Patient Satisfaction Survey

Thanks for your time.Please click submit to send us your replies

Thanks for your time.
Please click submit to send us your replies