LeadingAge Indiana Survey

As healthcare providers in unforeseen times, we know that your time is more valuable than ever. Please complete this short survey to be entered into a drawing to win a Gift Basket (valued at $75.00). Just one small way in which we can thank you for your time and honesty.

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* 1. Please enter your information below.

Name *

Company *

State/Province

Email Address *

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* 2. Title

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* 3. What type of facility do you work at?

Skilled Nursing Facility

Assisted Living Community

CCRC

Hospital with an LTC Unit

Sub acute Care Facility

Other (please specify)

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* 4. What is your facility ownership?

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* 5. What size of facility do you work at?

0-50 beds

51-100 beds

100-150 beds

150-250 beds

250+ beds

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* 6. Who is your current pharmacy provider?

PharMerica

Omnicare

PCA

Partners

Pharmascript

Remedi

Guardian

Pharmcare USA

Consonus

InTouch Pharmacy

Other (please specify)

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* 7. How likely is it that you would recommend your pharmacy to a friend or colleague?

NOT AT ALL LIKELY

EXTREMELY LIKELY

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* 8. On a scale of 0-10, please rate your pharmacy's service performance during the pandemic.

0 Extremely Poor Service

Neutral

10 Excellent Service

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 9. What is your primary job function?

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* 10. What, if anything, has your current pharmacy provider supplied, during this pandemic, to make your job easier?

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* 11. During these unprecedented times, are there any pharmacy provider services that you wish were offered to offset some of the additional burden of the pandemic?