Medication Adherence

The following survey was developed by the Clinical and Patient Educators Association (CPEA) to assess your use of prescription medications for ongoing medical conditions. All answers will remain completely anonymous.

* 1. Please specify on whose behalf you are completing this survey (or please specify who is completing this survey):

* 2. Please provide the age range of the patient:

* 3. Patient is:

* 4. Please select the therapeutic areas in which the patient has/had a healthcare condition during the past year: