Customer Satisfaction Survey Let us know how we are doing! Question Title * 1. Did the pharmacy personnel treat you with respect, act in a professional manner, and offer timely/prompt assistance? Always Somewhat Average Not really Not at all OK Question Title * 2. Were you offered counseling and instruction on your drug therapy and delivery devices? Yes No Not Applicable OK Question Title * 3. Was the instruction you received clear, concise, and understandable? Yes No Not applicable OK Question Title * 4. Was the pharmacy team able to answer all of your questions and/or meet all of your needs? Yes No Not Applicable OK Question Title * 5. Overall, how satisfied are you with Custom Rx Pharmacy & Wellness Concepts? Very satisfied Somewhat satisfied Neither satisfied nor dissatisfied Somewhat dissatisfied Very dissatisfied OK Question Title * 6. How likely is it that you would recommend Custom Rx Pharmacy & Wellness Concepts to a friend or colleague? NOT AT ALL LIKELY EXTREMELY LIKELY 0 1 2 3 4 5 6 7 8 9 10 0 1 2 3 4 5 6 7 8 9 10 OK Question Title * 7. How long have you been a customer of Custom Rx Pharmacy & Wellness Concepts? This is my first purchase Less than six months Six months to a year 1 - 2 years 3 or more years I haven't made a purchase yet OK Question Title * 8. Please include any comments that may help us better serve you. OK DONE