Pharmacy Service Feedback
Wait, counselling, stock, and privacy at the counter that sees everyone.
4 questions · 1 page · about 2 minutes to answer · fully editable after you start
Pharmacies are healthcare's highest-frequency touchpoint and quietest feedback zone. This survey measures the counter experience: prescription wait times, whether medication counselling actually happened, stock reliability for repeat medications, and the privacy question – whether sensitive conversations happen within earshot of the queue.
The counselling-happened score matters clinically: patients who were told how to take it correctly adhere better, and the pharmacist who explains is the cheapest adherence programme in medicine.
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Page 1
Your pharmacy visit
This survey is about your recent visit to our pharmacy. Tell us how the service, the advice and the stock levels worked for you. It takes about 2 minutes. This form is not an emergency service. If you need urgent medical help, call your local emergency number.
Q1.How would you rate each part of the service?*
| Poor | Fair | Good | Excellent | Not applicable | |
|---|---|---|---|---|---|
| Wait time | |||||
| Explanation of how to take your medication | |||||
| Stock availability | |||||
| Privacy at the counter | |||||
| Staff courtesy |
Q2.Was your medication in stock?*
- Yes
- Partially - ordered the rest
- No - had to come back or go elsewhere
Q3.Any question about your medication you left with unanswered?
Q4.How likely are you to keep using this pharmacy?
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