Patient Satisfaction Survey

Please indicate your agreement with the following statements by checking the corresponding box.

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
The Sunray Drugs Specialty staff was professional in their interactions with you.
The Sunray Drugs Specialty staff was helpful in answering all of your questions.
You were satisfied with the way your questions were answered.
The representative that you spoke with was knowledgeable.
The staff acts in your best interest.
Sunray Drugs Specialty was able to meet your needs.
You were satisfied with the patient management program information on medical use, possible side effects, and other related information provided to you.
The amount of information you received during the patient management program session was the right amount for a phone call.
It is easy to contact Sunray Drugs Specialty whenever you have a question or concern.
You received your medication in good condition so that there was no disruption in your course of treatment.
Your medications are delivered within the time frame you were given.
The Sunray Drugs Specialty delivery staff was friendly upon delivery of your medication.
Sunray Drugs Specialty filled your prescription accurately.
It is easy to reach a pharmacist when needed.
It was an easy process to enroll as a patient at Sunray Drugs Specialty.
The service provided by Sunray Drugs Specialty during initial fill and refills has been excellent.
My overall experience with Sunray Drugs Specialty has been excellent.

Comments or Concerns:
What did we do really well? What could we do better? Do you have any suggestions for improving our service?
Please rate your overall satisfaction of Sunray Drugs Specialty:

1

2

3

4

5

1 is Not satisfied, 5 is Extremely satisfied
Should be Empty: