Survey – Oncology & Hematology Specialists, P.A.

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Reach us at Our Office:

973-316-1701

1-888-708-8585

973-316-1708

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Survey

Home
Services
COVID-19 Protocols
Our Team
Survey

973-316-1701

1-888-708-8585

973-316-1708

Facebook Twitter Instagram

Reach us at Our Office:

973-316-1701

1-888-708-8585

973-316-1708

Facebook Twitter Instagram

Survey

1. Convenience of receiving prescriptions from OHS Dispensary that filled your prescription.

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Don’t know

2. Time involved in receiving prescriptions from the OHS Dispensary

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Don’t know

3. Your interaction with the OHS Staff Dispensary that filled your prescription

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Don’t know

4. General Satisfaction with OHS Dispensary that filled your prescription

Very Satisfied

Satisfied

Dissatisfied

Very Dissatisfied

Don’t know

5. Has OHS Dispensary that filled your prescription helped you with any co-pay/foundation assistance?

Yes

No

Don’t Know

6. Where would you prefer to fill your oncology medications?

Pharmacy in doctor’s office

Mail order

Pharmacy outside of doctor’s office

No preference

7. Please add additional comments or explanations to previous questions(s):

8. Gender

Female

Male

Other

9. Zip Code

10. Would you like someone from our practice pharmacy to contact you? If so, please use the comment box in #7 to include reasons for call.

Yes

No

Δ

Reach Us Today!

333 Route 46 West
Mountain Lakes
New Jersey, 07046
973.316.1701

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