The form aims to collect anonymous and useful information from our customer and non customers to improve on existing services and design products that meets consumer's expectation.

FULL NAME *
Email *
Phone
Which of the following band describes your age group?


How long have you been a customer of our company?
When did you last purchase from Medplus Pharmacy?
Can you describe your experience in our store using the words below?
Which of the following words would you use to describe our services? Select all that apply


What areas of our practice requires improvement from your own observation? Tick all that apply


If you haven't shopped with Medplus Pharmacy or have stopped shopping with us, which option(s) best describe your reason?
Please tell us your favorite retail pharmacy store and why?