Survey

Approximately how many prescriptions do you have filled during an average month?

Are you covered by the insurance plan offered by New Hanover Regional Medical Center?

  Yes
  No
  None

Which is your preferred method for refilling a prescription when you need to?

What is your preferred method of payment for your prescriptions?

How do you usually find out about new employee benefits

If Other, please specify:

Have you ever purchased over-the-counter medicines from the Employee Pharmacy?

  Yes
  No
  None

Where in the network do you work most of the time?

If Other, please specify:

Please indicate if you are a

What is your age?

Have you used the Employee Pharmacy to fill your prescriptions?

  Yes      No      Other      None

If Other, please specify:

Transferring my prescriptions to the Employee Pharmacy

1 =  1     2     3     4     5 = 5     None

The convenience of the location

1 =  1     2     3     4     5 = 5     None

Getting prescriptions filled quickly

1 =  1     2     3     4     5 = 5     None

Please select the choice that most closely answers why you have not used the Employee Pharmacy

If Other, please specify:

What time is most convenient for you to go to a pharmacy?

If Other, please specify:

What would make you consider switching to the Employee Pharmacy in the future?

Would you be interested in attending health screenings at the Employee Pharmacy?

  Yes      No      Other      None

If Other, please specify:

Please check which screenings may be of interest to you.

If Other, please specify:

Would you be willing to pay a small fee for health screenings at the Employee Pharmacy?

  Yes      No      Other      None

If Other, please specify:

Which statements best describe your average work day?

How would you prefer for the medical center to communicate information to you in the future?

Feel free to make additional comments in the space below