Community Pharmacy Patient Questionnaire

Complete this questionnaire and let us know how you feel about our service.

Q1 - How satisfied were you with the time it took to provide your prescription and/or any other NHS services you required?

Q1 - Thinking about any previous deliveries as well as today's, how would you rate the pharmacy on the following factors?

a) Was the delivery on time i.e did you run out medication before receiving your medication.

b) Was the driver polite/helpful with any queries you may of had.

Q2 - Again, including any previous visits to this pharmacy or phone calls made, how would you rate the pharmacist and the other staff who work there?
Please tick one box for each aspect of the service listed below, to show how good or poor you think it is:

a) Being polite and taking the time to listen to what you want

b) Answering any queries you may have

c) The service you received from the pharmacist

d) The service you received from the other pharmacy staff

e) Providing an efficient service

f) The staff overall

Q3 - Thinking about all the times you have used this pharmacy, how well do you think it provides each of the following services?

a) Providing advice on a current health problem or a longer term health condition

b) Providing general advice on leading a more healthy lifestyle

c) Disposing of medicines you no longer need

d) Providing advice on health services or information available elsewhere

Q7 - Have you ever been given advice over the phone, about any of the following by the pharmacist or pharmacy staff?

a) Stopping smoking

b) Healthy eating

c) Physical exercise

Q8 - Which of the following best describes how you use this pharmacy?

Q9 - Finally, taking everything into account - the staff, and the service provided - how would you rate the pharmacy?

Q10 - If you have any comments about how the service from this pharmacy could be improved, please write them in here:

Q12 - Are you...

Q11 - How old are you?

Q13 - Which of the following apply to you:

Community Pharmacy Patient Questionnaire

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Pharmacy opens

MON-FRI 09:00-17:00

GPhC Registered Premises: 9010768

Owners: Dr Wisam Tatari, Mr Yaman Tatari

Superintendent Pharmacist: Mr Yaman Tatari (GPhC registration number 2061218)

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