SlateRx wants to better understand your perspective of the utilization management process as a prescriber. Please take a few minutes to let us know your experience with our processes as we use this feedback to create a better experience for those working with SlateRx.

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* 1. Name

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* 2. Organization

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* 3. Email address

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* 4. My preferred method of submitting a coverage determination request is by:

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* 5. Please rate the following statement.
The SlateRx coverage determination process prioritizes my patients' access to care.

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* 6. Please rate the following statement.
SlateRx processes my patients' coverage determination requests in a timely manner.

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* 7. Please rate the following statement.
SlateRx communicates about my patients' coverage determination requests in a manner that meets my needs.

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* 8. To improve your experience with SlateRx, when additional information is needed after you've submitted a request, how do you prefer to be contacted?

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* 9. It can often be difficult to obtain additional clinical information, and missing criteria may lead to unnecessary denials. Do you have any suggestions for improving our process to obtain missing clinical information from prescribers?

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* 10. How likely is it that you would recommend SlateRx to a friend or colleague?

Not at all likely
Extremely likely

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