


| The Greater Washington Partnership for Palliative and End-of-Life Care |

| Feedback Form for Opioid Stocking Issue |
| The Greater Washington Partnership (GWP) is investigating the issue of opioids not being stocked adequately in low income neighborhoods. To assist us in our research, we would appreciate your assistance by completing the form below if you or your patients have experienced an issue with opioid stocking at your local pharmacy. This information is for research purposes only and will remain strictly confidential. All fields are required. Thank you for your time and assistance in helping us to resolve this issue. |