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973-316-1701
1-888-708-8585
973-316-1708
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Home
Services
Bone Marrow Testing
Supplements and Nutrition Counseling
Oncology & Hematology Specialists Dispensary
Cutting-Edge Clinical Trials
DigniCap Scalp Cooling System
Ozential
COVID-19 Protocols
Our Team
Survey
973-316-1701
1-888-708-8585
973-316-1708
Facebook
Twitter
Instagram
Patient Portal
Reach us at Our Office:
973-316-1701
1-888-708-8585
973-316-1708
Facebook
Twitter
Instagram
Patient Portal
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
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Home
Services
Bone Marrow Testing
Supplements and Nutrition Counseling
Oncology & Hematology Specialists Dispensary
Cutting-Edge Clinical Trials
DigniCap Scalp Cooling System
Ozential
COVID-19 Protocols
Our Team
Survey
