Provider Survey

Physician Satisfaction Survey

Thank you for allowing us to provide you Pharmacy services. Please take a few minutes to give us your feedback on your experience. We value your comments and welcome any suggestions you may have to improve our services.

MARKING INSTRUCTIONS:
Please choose the most appropriate option for each question below.
Please explain any less than satisfied response(s) in the comment section below.

Please enable JavaScript in your browser to complete this form.

1. How would you rate your level of satisfaction with the following?

	Very Satisfied	Satisfied	Somewhat Satisfied	Neutral	Somewhat Dissatisfied	Dissatisfied	N/A
The staff was courteous and helpful	Very SatisfiedThe staff was courteous and helpful Very Satisfied	SatisfiedThe staff was courteous and helpful Satisfied	Somewhat SatisfiedThe staff was courteous and helpful Somewhat Satisfied	NeutralThe staff was courteous and helpful Neutral	Somewhat DissatisfiedThe staff was courteous and helpful Somewhat Dissatisfied	DissatisfiedThe staff was courteous and helpful Dissatisfied	N/AThe staff was courteous and helpful N/A
I would recommend SafeScript Pharmacy to other physicians	Very SatisfiedI would recommend SafeScript Pharmacy to other physicians Very Satisfied	SatisfiedI would recommend SafeScript Pharmacy to other physicians Satisfied	Somewhat SatisfiedI would recommend SafeScript Pharmacy to other physicians Somewhat Satisfied	NeutralI would recommend SafeScript Pharmacy to other physicians Neutral	Somewhat DissatisfiedI would recommend SafeScript Pharmacy to other physicians Somewhat Dissatisfied	DissatisfiedI would recommend SafeScript Pharmacy to other physicians Dissatisfied	N/AI would recommend SafeScript Pharmacy to other physicians N/A
The services provided met my needs and expectations	Very SatisfiedThe services provided met my needs and expectations Very Satisfied	SatisfiedThe services provided met my needs and expectations Satisfied	Somewhat SatisfiedThe services provided met my needs and expectations Somewhat Satisfied	NeutralThe services provided met my needs and expectations Neutral	Somewhat DissatisfiedThe services provided met my needs and expectations Somewhat Dissatisfied	DissatisfiedThe services provided met my needs and expectations Dissatisfied	N/AThe services provided met my needs and expectations N/A
SafeScript Pharmacy is easier to use then other pharmacies	Very SatisfiedSafeScript Pharmacy is easier to use then other pharmacies Very Satisfied	SatisfiedSafeScript Pharmacy is easier to use then other pharmacies Satisfied	Somewhat SatisfiedSafeScript Pharmacy is easier to use then other pharmacies Somewhat Satisfied	NeutralSafeScript Pharmacy is easier to use then other pharmacies Neutral	Somewhat DissatisfiedSafeScript Pharmacy is easier to use then other pharmacies Somewhat Dissatisfied	DissatisfiedSafeScript Pharmacy is easier to use then other pharmacies Dissatisfied	N/ASafeScript Pharmacy is easier to use then other pharmacies N/A
SafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination	Very SatisfiedSafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination Very Satisfied	SatisfiedSafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination Satisfied	Somewhat SatisfiedSafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination Somewhat Satisfied	NeutralSafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination Neutral	Somewhat DissatisfiedSafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination Somewhat Dissatisfied	DissatisfiedSafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination Dissatisfied	N/ASafeScript Pharmacy helped improve my patient’s adherence with their compliance and care coordination N/A
Ability to reach a person by phone who could answer your question	Very SatisfiedAbility to reach a person by phone who could answer your question Very Satisfied	SatisfiedAbility to reach a person by phone who could answer your question Satisfied	Somewhat SatisfiedAbility to reach a person by phone who could answer your question Somewhat Satisfied	NeutralAbility to reach a person by phone who could answer your question Neutral	Somewhat DissatisfiedAbility to reach a person by phone who could answer your question Somewhat Dissatisfied	DissatisfiedAbility to reach a person by phone who could answer your question Dissatisfied	N/AAbility to reach a person by phone who could answer your question N/A
Explanation of whom to call if there is an issue with your order	Very SatisfiedExplanation of whom to call if there is an issue with your order Very Satisfied	SatisfiedExplanation of whom to call if there is an issue with your order Satisfied	Somewhat SatisfiedExplanation of whom to call if there is an issue with your order Somewhat Satisfied	NeutralExplanation of whom to call if there is an issue with your order Neutral	Somewhat DissatisfiedExplanation of whom to call if there is an issue with your order Somewhat Dissatisfied	DissatisfiedExplanation of whom to call if there is an issue with your order Dissatisfied	N/AExplanation of whom to call if there is an issue with your order N/A

3527938000 / 3527489900

Provider Survey

Physician Satisfaction Survey

1. How would you rate your level of satisfaction with the following?

2. How can we improve our services?

3. Comments:

4. Signature (Optional)

For more information

Safescript Pharmacy | Bushnell

Safescript Pharmacy | Wildwood