Thank you for taking the time to complete this questionnaire.

If you would be willing to share your suggestions and ideas with AFA, please contact: info@atrialfibrillation-au.org

For further information on Atrial Fibrillation, visit: http://www.atrialfibrillation-au.org/

Question Title

* 1. Are you a

Question Title

* 2. Date of birth of AF patient

Date

Question Title

* 3. Gender of AF patient

Question Title

* 4. Where are you located in Australia?

Question Title

* 5. Have you / the patient been diagnosed with any of the following?

Question Title

* 6. If any, what symptoms do you / the patient experience?

Question Title

* 7. Are you / the patient currently seen by?

Question Title

* 8. Have you / the patient undergone any of the following tests?

Question Title

* 9. Please indicate the medications you / the patient are currently taking:

Question Title

* 10. Have you / the patient experienced a TIA or stroke?

Question Title

* 11. Do you have / is there a history of high blood pressure?

Question Title

* 12. Have you / the patient been diagnosed with heart failure?

Question Title

* 13. Have you / the patient undergone any of the following procedures?

Question Title

* 14. Are you satisfied with your current treatment?

T