Pharmacy Patient Satisfaction Survey

D EFENSE HEALTH AGENCY

7700 ARLINGTON BOULEVARD, SUITE 5101

FALLS CHURCH, VIRGINIA 22042-5101

OMB CONTROL NUMBER: 0704-0553

OMB EXPIRATION DATE: 05/31/2025

AGENCY DISCLOSURE NOTICE

The public reporting burden for this collection of information, 0704-0553, is estimated to average 10 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding the burden estimate or burden reduction suggestions to the Department of Defense, Washington Headquarters Services, at [email protected]. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

In-person pharmacy patient survey script:

Hello,

My name is XXXX and I am from the Pharmacy Operations Division at Defense Health Agency Headquarters. How are you doing today?

Would you be interested in participating in a four-question survey today to help us improve our pharmacy operations and patient satisfaction? The survey responses will be kept completely anonymous, and we are not collecting any personally identifiable information. We anticipate this will take 10 minutes of your time, but you can stop at any time if needed, and skip any questions. There is no penalty for not participating.

Question 1: What would you like to see improved in the pharmacy benefit and/or services?

Question 2: What would you change at the MTF pharmacy?

Question 3: Why do you use the MTF pharmacy instead of mail or retail pharmacy?

Question 4: What do you like about the pharmacy benefit, for example, do you like that when you PCS [permanent change of station] you can get the same medication from each location?

Question 5: Have you ever filled a medication at the MTF Pharmacy that required a ‘Prior Authorization’? If so, did you experience any challenges when filling that medication?

Thank you so much for the valuable feedback to help us improve. Your trust in military medicine is important to us, and we will continue to make every effort possible to provide you the world-class care that you deserve. Have a wonderful day!