PRESCRIPTION FOR EDUCATION SURVEY
We would like to know if our "prescription drug bottles" make any difference and what you thought of them. Please answer a few questions about the bottle you saw to help us learn more.
*
1
. Where did you see the prescription drug bottle?
Where did you see the prescription drug bottle?
*
2
. How much do you know now about the possible harms of using prescription drugs without a doctor's prescription
compared to what you knew before
you saw the prescription drug bottles?
How much do you know now about the possible harms of using prescription drugs without a doctor's prescription
compared to what you knew before
you saw the prescription drug bottles?
Same as before
A little more
Somewhat more
A lot more
*
3
. Will you change how you store and dispose of your prescription medications after seeing the prescription drug bottles?
Will you change how you store and dispose of your prescription medications after seeing the prescription drug bottles?
Definitely not
Probably not
Probably will
Definitely will
*
4
. Do you think the prescription drug bottles are a good way to help people understand prescription misuse and how they can prevent it?
Do you think the prescription drug bottles are a good way to help people understand prescription misuse and how they can prevent it?
Definitely not
Probably not
Probably are
Definitely are
5
. Please provide any comments you have to help us improve what we are doing to prevent prescription drug misuse.
Please provide any comments you have to help us improve what we are doing to prevent prescription drug misuse.
Powered by
SurveyMonkey
Check out our
sample surveys
and create your own now!
Javascript is required for this site to function, please enable.