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IC and Medication Survey
ICA is conducting a survey for the next issue of the
ICA Update
. This survey will focus on IC and medication and should take approximately 5-10 minutes to complete. Thank you for taking a moment to provide your feedback.
1.
What prescription medications related to IC and its symptoms do you take?
2.
What non-prescription/over-the-counter medications do you take?
3.
In the last year, have you had difficulty obtaining prescription medications related to IC? Which ones, and why?
4.
What ways have you found to reduce the cost or obtain prescription medications (e.g., offers, coupons, generics, alternative sources, etc.)?
5.
What else should we know about the challenges of obtaining medications related to IC?
6.
Are you willing to be quoted and/or interviewed for the
ICA Update
magazine? Your information will remain anonymous if you don’t want your name printed.
Yes
No
7.
If yes, please provide your contact information below:
Name
State/Province
Email Address
Phone Number
Thank you for taking time to provide feedback regarding IC and medications. Please click the "done" button below to submit your response.