Broadway Specialty Pharmacy Patient Survey Thank you for allowing us to provide you Specialty Pharmacy services. Please take a few minutes to give us your feedback on your experience. We value your comments and welcome any suggestions you may have to improve our services. OK Question Title * 1. Overall, how satisfied are you with your specialty pharmacy experience? Very Satisfied Satisfied Neutral Unsatisfied Very Unsatisfied N/A OK Question Title * 2. Does the pharmacy provide information on any financial assistance program? Select all that apply. Co-pay Card Manufacturer Support Funding Support N/A OK Question Title * 3. How would you rate the welcome call you received from your pharmacy introducing you to the specialty program? Excellent Above Average Average Below Average Poor N/A OK Question Title * 4. Please rate the call(s) you receive regarding updates on your specialty medication(s)? Excellent Above Average Average Below Average Poor N/A OK Question Title * 5. Please rate the 7-day follow-up call after receiving your specialty medication? Excellent Above Average Average Below Average Poor N/A OK Question Title * 6. Please rate the promptness of pharmacy staff answering your call? Excellent Above Average Average Below Average Poor N/A OK Question Title * 7. Do you receive the refills on your specialty medication(s) on-time? Always Occasionally Sometimes Rarely Never N/A OK Question Title * 8. How likely is it that you would recommend this pharmacy to a friend or colleague? Very Likely Somewhat Likely Neutral Somewhat Unlikely Very Unlikely N/A OK Question Title * 9. Has there been an incident where you were dissatisfied with the service? Yes No If yes, please explain OK Question Title * 10. What suggestions do you have as to how we can improve our services? OK DONE