Patient Satisfaction Survey

You can always press Enter⏎ to continue

Tell us what you think

Tell us what you think

By taking this survey, you verify that you are a current or former patient of IV Solutions RX.

12Questions

HIPAA

Compliance

1
Was your call handled in a timely manner?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
2
How would you rate the level of service you received?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
3
How would you rate the professionalism of the staff?For example, were they respectful, courteous, caring, informative
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
4
Was the medication received in a timely manner?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
5
Was the patient management program helpful and informative while taking your medication?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
6
Did the nurse go over your medication and explain your disease state to you during your visit?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
7
Did the pharmacists explain the possible side effects of your medication?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
8
Were you kept informed throughout the process?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
9
How would you rate your overall experience with IV Solutions RX?
Very Poor
Poor
Average
Good
Excellent
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Very Poor
Row 0, Column 0
Poor
Row 0, Column 1
Average
Row 0, Column 2
Good
Row 0, Column 3
Excellent
Row 0, Column 4
10
How likely are you to recommend or use our services in the future?
Not at All
Not Really
Undecided
Somewhat
Very Much
Please rate
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Row 0, Column 3
Row 0, Column 4
Please rate
Not at All
Row 0, Column 0
Not Really
Row 0, Column 1
Undecided
Row 0, Column 2
Somewhat
Row 0, Column 3
Very Much
Row 0, Column 4
11
CommentsPlease enter your comments below
Huge
Large
Normal
Small
Ok
Ok
12
Please verify that you are human* This field is required.
Should be Empty:

Question Label

1 of 12See AllGo Back