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Mind Your Meds
Post-Presentation Form
Please answer the questions below to help us develop education and training to improve the health of older adults. Thank you for your participation!
*
1.
Do you plan to review and/or update your medication list (or the list of someone that you care for) prior to your next health care appointment?
(Required.)
Yes
No
I don't know
*
2.
Do you plan to discuss your medications (or those of someone that you care for) with a doctor or health care provider?
(Required.)
Yes
No
I don't know
*
3.
Do you plan to recommend to someone else that they take a medication list to their next doctor or health care provider appointment?
(Required.)
Yes
No
I don't know
4.
I am a family caregiver* for an adult over the age of 65. *Family caregiver: Provides care or assistance to an adult(s) age 65 or older (including spouses, parents, other relatives, close friends or neighbors) such as help with personal care, medications, shopping, transportation, home maintenance or visiting to check on their wellbeing.
Yes
No
5.
What else would you like to know about medication safety or preparing for your next health care provider visit?
