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Pharmacy customer feedback survey
Healthcare
Pharmacy customer feedback survey
Find out how customers felt about their prescription and what to improve next.
11 fields Ready to publish
What's included
- 1Overall ratingRequiredRating
- 2What could we do better?Long text
- 3PhonePhone
- 4Date of birthDate
- 5Preferred appointment dateDate
- 6Reason for visitRequiredLong text
- 7Current medicationsLong text
- 8Allergies or medical conditionsLong text
- 9Emergency contactShort text
- 10Insurance providerShort text
- 11Which part of the experience are you rating?Short text
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