At Lakeland Pharmacy, we are committed to providing you with top quality products and service. Because you, the customer, are the most important part of our business, we value your opinion. Your input will help us identify areas in which we can improve services and better meet your needs in the future. Please take a few moments to share your thoughts and ideas with us. We greatly appreciate your participation in this survey!

Date:
Was the equipment and/or supplies promptly delivered?
5       4       3       2       1
Was the equipment and/or supplies clean when received?
5       4       3       2       1
Does the equipment operate properly?
5       4       3       2       1
Were adequate instructions provided for safe use of the equipment?
5       4       3       2       1
Was the staff courteous and helpful?
5       4       3       2       1
I was informed that Lakeland Pharmacy staff are available for after hour emergencies.
5       4       3       2       1
I would recommend Lakeland Pharmacy to my friends and family.
5       4       3       2       1
Overall, the services I received were to my satisfaction.
5       4       3       2       1
The service(s) I received met my healthcare needs.
5       4       3       2       1
How can we improve to meet your safety needs:
Comments:
How did you hear about Lakeland Pharmacy?
Doctor Family/Friend Insurance Hospital Discharge Planner Newspaper/Radio
Other:
Name (optional):
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In an effort to prevent abuse of this survey, we ask that you please answer the challenge question below. You may generate a new question if it is hard to read.