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Junxion Pharmacies
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Staff Rating Form
This form focuses on key aspects of customer service and is designed to be quick and easy for customers to fill out.
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Staff Member Name
Staff Member Name 1
Staff Member Name 2
Staff Member Name 3
Date of Interaction
How would you rate the staff member's friendliness and attitude?
*
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
How would you rate the staff member's knowledge and competence in handling your needs?
*
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
How would you rate the staff member's communication skills?
*
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
How would you rate the efficiency of the service provided?
*
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
How would you rate your overall experience with the staff member?
*
1. Poor
2. Fair
3. Good
4. Very Good
5. Excellent
Additional Comments
Please provide any additional comments or feedback
Your Name
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