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A Drug Topics® Readership Survey
To thank you for your time, your name will be entered in a prize drawing for one of four $100 VISA gift cards.
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* 1. Please describe your primary area of employment.

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* 2. Which of the following best describes your job title?

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* 3. Which of the following are common causes of constipation? (select all that apply)

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* 4. Based on your understanding, what percentage of men and women have a bowel movement once every day?

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* 5. Which OTC treatment for occasional constipation do you most commonly recommend?

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* 6. MiraLAX is categorized as a(n):

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* 7. In what form is MiraLAX taken?

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* 8. MiraLAX generally produces a bowel movement in ___ to ____ days.

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* 9. Which brands of laxative do you recommend most often (list your top 3 by noting a 1, 2, or 3 next to the brand)?

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* 10. Which brands of laxative do you recommend most often as first-line options (list your top 3 by noting a 1, 2, or 3 next to the brand)?

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* 11. What level of severity of constipation would you recommend MiraLAX for (check all that apply)?

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* 12. Please provide your name and e-mail address to enter into a drawing to win one of four $100 VISA gift cards.

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