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* 1. Do you receive your healthcare coverage and treatment through the Veterans Health Administration?

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* 2. Have you ever had difficulties accessing your prescribed medication due to coverage and formulary restrictions?

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* 3. Have you ever been required to try and fail on a medication before accessing the medication which your doctor had initially prescribed?

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* 4. Have you ever had to go through a “Non-Formulary Request” process in order to access your medication? (A non-formulary request is when forms need to be submitted in order to request coverage of a medication that is not included on your healthcare plan’s formulary, or list of covered medications.)

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* 5. If you answered yes to one or more of the above questions, did you have negative health consequences as a result of the delay in treatment?

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* 6. Are you willing to share what disease you are seeking treatment for (i.e. rheumatology, gastroenterology, oncology, cardiology, neurology, rare disease, etc.)

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* 7. Would you be willing to speak to (RetireSafe / Alliance for Patient Access) further about your experience?

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