Phone: 706.721.0131 OR 1.800.736.2273 ext.0131 Fax: 706.721.0754

Medication Access Program (MAP) Patient Survey

Please read each of the statements carefully and circle the number that describes your opinion. We welcome your comments and are interested in what you have to say so that we may improve the program. Thank you very much for your time and effort in completing this survey.

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