Provider Feedback Form

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The medication ordered was received in a timely manner by the office or my patient. The medication ordered was received in a timely manner by the office or my patient. Strongly Agree Agree Neutral Disagree Strongly Disagree

Chemistry Rx services met the needs and expectations for my office and patients. Chemistry Rx services met the needs and expectations for my office and patients. Strongly Agree Agree Neutral Disagree Strongly Disagree

I received satisfactory information regarding the medication, and any questions my office had were answered promptly I received satisfactory information regarding the medication, and any questions my office had were answered promptly Strongly Agree Agree Neutral Disagree Strongly Disagree

The representative I spoke to was caring, knowledgeable and responsive to the needs of my office and patient The representative I spoke to was caring, knowledgeable and responsive to the needs of my office and patient Strongly Agree Agree Neutral Disagree Strongly Disagree

Chemistry Rx provided better service than other pharmacies our office has used. Chemistry Rx provided better service than other pharmacies our office has used. Strongly Agree Agree Neutral Disagree Strongly Disagree

This office would recommend Chemistry Rx to a friend, family member, or another physician office. This office would recommend Chemistry Rx to a friend, family member, or another physician office. Strongly Agree Agree Neutral Disagree Strongly Disagree

The ordering process was easy to access and complete. The ordering process was easy to access and complete. Strongly Agree Agree Neutral Disagree Strongly Disagree

Additional Comments

Is there any medication/product you would like to see us offer?