Pharmacy customer survey template
Wait time, advice, privacy, stock availability and staff, for community pharmacies.
4 questions · about 2 minutes to complete · free on every plan
Free account required. The template is copied into your workspace; edit anything before publishing.
- When to use it
- Via QR code at the counter or on the receipt.
- Who it is for
- Pharmacy customers.
How to use this template
- Send it within 48 hours of the visit; response rates and recall both fall the longer you wait.
- Ask about communication ('explained things in a way I understood') before overall satisfaction.
- Do not ask for diagnoses or medications in a general feedback survey.
Questions in the pharmacy customer survey template
1. How long did you wait to be served?
single choice · No wait, Under 5 minutes, 5–15 minutes, More than 15 minutes
2. Please rate your agreement:
matrix · Staff were helpful and knowledgeable, I could ask questions privately, What I needed was in stock, Advice was clear
3. How likely are you to recommend this pharmacy?
nps
4. What could we do better?
open text
What the results look like
IllustrativeSynthetic sample of 120 responses generated for this preview, not real survey data. Your results page shows the same charts for your own responses.
1.How long did you wait to be served?
120 answered| Answer | Count | Percent |
|---|---|---|
| No wait | 19 | 16% |
| Under 5 minutes | 20 | 17% |
| 5–15 minutes | 31 | 26% |
| More than 15 minutes | 50 | 42% |
2.Please rate your agreement:
120 answered| Statement | Strongly disagree | Disagree | Neutral | Agree | Strongly agree | n |
|---|---|---|---|---|---|---|
| Staff were helpful and knowledgeable | 7% | 20% | 13% | 20% | 40% | 120 |
| I could ask questions privately | 9% | 13% | 23% | 22% | 33% | 120 |
| What I needed was in stock | 6% | 18% | 24% | 20% | 33% | 120 |
| Advice was clear | 10% | 13% | 13% | 22% | 43% | 120 |
3.How likely are you to recommend this pharmacy?
120 answered| Answer | Count | Percent |
|---|---|---|
| 0 | 5 | 4% |
| 1 | 3 | 3% |
| 2 | 7 | 6% |
| 3 | 7 | 6% |
| 4 | 8 | 7% |
| 5 | 9 | 8% |
| 6 | 10 | 8% |
| 7 | 19 | 16% |
| 8 | 17 | 14% |
| 9 | 17 | 14% |
| 10 | 18 | 15% |
How to read these questions
- single choice: Read the share choosing each option, then cross-tab by a segment question to see who differs.
- matrix: Compare rows on the same column (for example, % agree) to find the weakest statement, then look at who rates it lowest.
- nps: NPS = % promoters (9–10) − % detractors (0–6). Check the margin of error before calling a change between two periods.
Frequently asked questions
Does a patient satisfaction survey need HIPAA safeguards?
If it collects no health information and is anonymous, generally no. If you link responses to patient records or ask about conditions, treat it as protected health information and get advice.
How long does the pharmacy customer survey take to complete?
About 2 minutes: 4 questions, most of them single-tap. Every question can be edited, removed or reordered in the builder before you publish.
Is this template free to use?
Yes. Every template is included on the Free plan. Sign up, click Use this template, and it is copied into your workspace where you can edit it, add your logo and share it by link, email or embed.
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