Business Review-new

Thank you for taking the time to fill out our business review.

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Customer Info

Name*

Email*

Your Community*

Your Regional Director*

Your Technician

How is your designated account technician doing?

How is your delivery? Do you get meds when you expect them?

When was your last consulting service?

Do you need additional Heartland Pharmacy training (Serenity Engage, Heartland Connect)?

Equipment

Estimate the number of cards in the med cart

Number of scripts

Photos of Equipment

Drop files here or

Max. file size: 1 GB.

Take pictures of any issues/concerns/repairs requested, inventory all equipment provided by Heartland, including med cart serial numbers, colors, key numbers, etc., and laptop/scanners/fax machine quantities.

Celebration of Partnership

Kudos*

names of anyone you think deserves a shoutout

Why do you still use Heartland Pharmacy?*

Review the contract (Equipment, cost-share, consulting, term, etc.):*

Upcoming community events:*

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