Pharmacy Feedback Form

Gather feedback from customers about their experience at the pharmacy.

No credit card required

About this template

The Pharmacy Feedback Form is designed to gather valuable feedback from customers regarding their experience at the pharmacy. This template helps pharmacy owners and managers understand their customers’ satisfaction levels and identify areas for improvement.

Question 1 in this form is a single-select question that asks customers if they found the pharmacy staff helpful and knowledgeable. Based on their response, the form either proceeds to the next question or displays a message prompting them to provide more details if they answered negatively.

Question 2 is a textarea question that allows customers to describe their experience and provide suggestions for improvement.

Question 3 is a single-select question asking customers to rate the waiting time at the pharmacy. This helps assess the efficiency of service and identify potential bottlenecks.

Question 4 is a NPS question using a scale of 0-10 to measure the customers’ likelihood of recommending the pharmacy to others. A higher rating indicates higher customer satisfaction.

If customers provide a rating of 9 or above in Question 4, Question 5 appears as a textarea question to capture specific aspects appreciated by customers.

Question 6 is a final textarea question where customers can provide any additional comments or suggestions they may have.

The Pharmacy Feedback Form aims to help pharmacies enhance their customer experience, improve staff knowledge and assistance, reduce waiting times, and address any concerns or suggestions made by customers. By utilizing this form, pharmacies can gain valuable insights to optimize their services and ensure customer satisfaction.

Give your business a boost with TRACX®

Sign up for free and get everything you need to turn visitors into customers, and customers into super-fans — all in one platform.

  • TRACX is free forever
  • Upgrade anytime, cancel anytime
  • No coding necessary
  • Get set up in seconds
  • GDPR & CCPA-ready
  • Hosted in EU datacentres