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Comments/Feedback
We appreciate your comments and feedback about our service and your compounded
prescription(s).
Was our service
Excellent
Good
Satisfactory
Unsatisfactory
Is there anything we can improve?
Can we provide any additional service to better meet your needs?
Comments about your compounded prescription(s)
Please enter the Rx#, then answer any questions that apply to that prescription.
Rx#
Did you have any problems with administration?
No
Yes
If yes, please explain.
Did we explain how to use your medication clearly?
No
Yes
If yes, please explain.
Do you like the consistency and/or flavor?
Do you have any questions about your therapy?
Rx#
Did you have any problems with administration?
No
Yes
If yes, please explain.
Did we explain how to use your medication clearly?
No
Yes
If yes, please explain.
Do you like the consistency and/or flavor?
Do you have any questions about your therapy?
(Type the 5 alphanumeric figures on the left image.)
Can't see the code clearly?
Maida Pharmacy
121 Massachusetts Ave.
Arlington, MA 02474
781-643-7840
781-643-0174 fax
Copyright © 2006-2011 Maida Pharmacy and
Storey Marketing
.
