ACG, AGA, and ASGE is seeking feedback on provider experiences obtaining exceptions to policies that limit access to low-volume bowel preparations.  Please complete this form for each company in which you are experiencing barriers to access for your patients.                            

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* 1. Please indicate the name of the pharmacy benefit manager (PBM) in which you are trying to secure a low-volume preparation for your patient. (Check all that apply)

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* 2. Did you submit a request through the PBM's Exceptions Process?

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* 3. Please indicate the basis for the exception request.

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* 4. Have you received a response? 

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* 5. If yes, how long did it take you to receive a response?

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* 6. Please provide feedback regarding your experience.

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* 7. Please provide your contact information. 

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