CPESN USA Business/Vendor Complaint Form
CPESN USA values our working relationships with CPESN pharmacies. We will not sell or distribute the contact information for our participating pharmacies to third parties. This form is for CPESN pharmacies to report concerns regarding businesses/vendors that appear to be doing one of the following: 1) misrepresenting their relationship with CPESN USA or CPESN networks, and/or 2) exhibiting aggressive behavior or messaging while conducting outreach to CPESN pharmacies or network leaders. CPESN USA will hold the name of your pharmacy in confidence but may share other details from your report with the business/vendor as an example of issues occurring in the marketplace.
Pharmacy Location (city and state)
Date of the Incident (if known)
Date Picker Icon
Name of Representative from Business/Vendor (if known)
Description of Incident
Please provide as many details as possible about what happened and why you view the situation as concerning/problematic, including name of business/vendor representative, day/time of interaction, specific language used, etc.
Should be Empty: