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ZONNIC Post-Sample Survey – Pharmilink Sampling Program

Thank you for participating in the Pharmilink Sampling program and receiving ZONNIC samples. We are conducting this follow-up survey to gather your valuable feedback on your experience with ZONNIC and the Pharmilink Sampling Program. Your insights are crucial for understanding the impact of ZONNIC on your practice and for improving future initiatives.

This survey should take approximately 5 minutes to complete. Your responses will be kept confidential and analyzed anonymously. Participation is completely voluntary.
1.How did you utilize the ZONNIC samples in your practice? (Select all that apply)
2.Did you receive any direct feedback from patients who tried ZONNIC samples?
3.Based on your experience or review, how would you rate your understanding of ZONNIC’s:
1 Not good understanding
2
3
4
5 Very good understanding
N/A
Mechanism of action
Intended use
Perceived Benefits
Risks/side effects
Appropriate patient population
Usage instructions
4.How has your overall perception of ZONNIC changed since receiving the samples?
Significantly more positive
Moderately more positive
No change
Moderately more negative
Significantly more negative
5.What factors most influenced your perception of ZONNIC after participating in the Pharmilink Sampling Program? (Select all that apply)
6.How likely are you to recommend ZONNIC to patients, compared to other NRTs?
Much more likely
Somewhat more likely
Equally likely
Somewhat less likely
Much less likely
7.To what extent do you agree with the following statements?
1 - Strongly Disagree
2
3
4
5 - Strongly Agree
ZONNIC is a potentially useful NRT option
Easy for patients to use
Effectively addresses cravings
I feel confident discussing it
Can improve patient outcomes
8.Are you open to being visited by a rep in person to learn more about ZONNIC?
9.Please indicate the province in which you currently practice:
10.Please provide your College of Physicians & Surgeons license number (not your billing #).
(NB. This is required to ship the gift card for completing both the pre-sample and post-sample surveys, to you.)