Fishpool Pharmacy Customer Feedback Survey

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* 1. When collecting your prescription did you:

Collect Straight Away

Wait in Pharmacy

Came Back Later

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* 2. How satisfied were you with the service you received?

Not at all satisfied

Not very satisfied

Fairly satisifed

Very satisfied

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* 3. Did you collect a prescription from this pharmacy for:

Yourself

Someone Else

Both

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* 4. Thinking about any previous visits to the pharmacy, how would you rate the pharmacy on the following factors

	Very Poor	Fairly Poor	Fairly Good	Very Good	Don't Know
Cleanliness of pharmacy	Cleanliness of pharmacy Very Poor	Cleanliness of pharmacy Fairly Poor	Cleanliness of pharmacy Fairly Good	Cleanliness of pharmacy Very Good	Cleanliness of pharmacy Don't Know
Comfort and convenience of the waiting areas	Comfort and convenience of the waiting areas Very Poor	Comfort and convenience of the waiting areas Fairly Poor	Comfort and convenience of the waiting areas Fairly Good	Comfort and convenience of the waiting areas Very Good	Comfort and convenience of the waiting areas Don't Know
Having in stock the medicines/appliances you need	Having in stock the medicines/appliances you need Very Poor	Having in stock the medicines/appliances you need Fairly Poor	Having in stock the medicines/appliances you need Fairly Good	Having in stock the medicines/appliances you need Very Good	Having in stock the medicines/appliances you need Don't Know
Offering a clear and well organised layout	Offering a clear and well organised layout Very Poor	Offering a clear and well organised layout Fairly Poor	Offering a clear and well organised layout Fairly Good	Offering a clear and well organised layout Very Good	Offering a clear and well organised layout Don't Know
How long you have to wait to be served	How long you have to wait to be served Very Poor	How long you have to wait to be served Fairly Poor	How long you have to wait to be served Fairly Good	How long you have to wait to be served Very Good	How long you have to wait to be served Don't Know
Having somewhere available where you can speak without being overheard, if you wanted to	Having somewhere available where you can speak without being overheard, if you wanted to Very Poor	Having somewhere available where you can speak without being overheard, if you wanted to Fairly Poor	Having somewhere available where you can speak without being overheard, if you wanted to Fairly Good	Having somewhere available where you can speak without being overheard, if you wanted to Very Good	Having somewhere available where you can speak without being overheard, if you wanted to Don't Know

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* 5. Again including any previous visits to this pharmacy, how would you rate the pharmacist and other staff who work there?

	Very Poor	Fairly Poor	Fairly Good	Very Good	Don't Know
Being polite and taking the time to listen to what you want	Being polite and taking the time to listen to what you want Very Poor	Being polite and taking the time to listen to what you want Fairly Poor	Being polite and taking the time to listen to what you want Fairly Good	Being polite and taking the time to listen to what you want Very Good	Being polite and taking the time to listen to what you want Don't Know
Answering any questions you may have	Answering any questions you may have Very Poor	Answering any questions you may have Fairly Poor	Answering any questions you may have Fairly Good	Answering any questions you may have Very Good	Answering any questions you may have Don't Know
The service you received from the pharmacist	The service you received from the pharmacist Very Poor	The service you received from the pharmacist Fairly Poor	The service you received from the pharmacist Fairly Good	The service you received from the pharmacist Very Good	The service you received from the pharmacist Don't Know
Providing an efficient service	Providing an efficient service Very Poor	Providing an efficient service Fairly Poor	Providing an efficient service Fairly Good	Providing an efficient service Very Good	Providing an efficient service Don't Know
The staff overall	The staff overall Very Poor	The staff overall Fairly Poor	The staff overall Fairly Good	The staff overall Very Good	The staff overall Don't Know

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

	Not at all well	Not very well	Fairly well	Very well	Never used
Providing advice on a current health problem or a longer term health condition	Providing advice on a current health problem or a longer term health condition Not at all well	Providing advice on a current health problem or a longer term health condition Not very well	Providing advice on a current health problem or a longer term health condition Fairly well	Providing advice on a current health problem or a longer term health condition Very well	Providing advice on a current health problem or a longer term health condition Never used
Providing general advise on leading a more healthy lifestyle	Providing general advise on leading a more healthy lifestyle Not at all well	Providing general advise on leading a more healthy lifestyle Not very well	Providing general advise on leading a more healthy lifestyle Fairly well	Providing general advise on leading a more healthy lifestyle Very well	Providing general advise on leading a more healthy lifestyle Never used
Disposing of medicines you no longer need	Disposing of medicines you no longer need Not at all well	Disposing of medicines you no longer need Not very well	Disposing of medicines you no longer need Fairly well	Disposing of medicines you no longer need Very well	Disposing of medicines you no longer need Never used
Providing advice on health services or information available elsewhere	Providing advice on health services or information available elsewhere Not at all well	Providing advice on health services or information available elsewhere Not very well	Providing advice on health services or information available elsewhere Fairly well	Providing advice on health services or information available elsewhere Very well	Providing advice on health services or information available elsewhere Never used

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* 7. Have you ever been given advice about any of the following by the pharmacist or pharmacy staff?

	Yes	No
Stopping Smoking	Stopping Smoking Yes	Stopping Smoking No
Healthy Eating	Healthy Eating Yes	Healthy Eating No
Physical Exercise	Physical Exercise Yes	Physical Exercise No

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* 8. Which of the following best describes how you use this pharmacy?

This is the pharmacy you choose to visit if possible

This is one of several pharmacies that you use when you need to

This pharmacy was just convenient for you today

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* 9. Finally taking everything into account - the staff, the shop and the service provided - how would you rate this pharmacy?

Poor

Fair

Good

Very Good

Excellent

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* 10. If you have any comments about how the service from this pharmacy can be improved please comment below:

These last few questions are just to help us categorise your answers

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* 11. How old are you?

16-19

20-24

25-34

35-44

45-54

55-64

65+

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* 12. Are you?

Male

Female

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* 13. Which of the following apply to you?

You have, or care for, children under 16

You are a carer for someone with a longstanding illness or infirmity

Neither