Skip to content

Teen Insight Medications and Treatment Survey

Thank you for continuing to provide information for this critical research project. Remember, your answers can only be viewed by ASF staff and anything with your name will not be shared with your parents or anyone else without your direct, written consent. This survey should only take approximately 2-3 minutes of your time.
1.Please type your first and last name.
2.Since your Alport syndrome diagnosis, how many nephrologists have you steadily seen to help monitor your kidney health?
3.Have you ever changed nephrologists for any reason? If so, please explain why.
4.Is a parent or guardian typically in the room with you during your nephrologist visits?
5.Do you feel comfortable enough in the understanding of your health situation to speak to your nephrologist without a parent or guardian present in the room if that were allowed?
6.Do you feel meetings with your nephrologist are primarily two-way conversations between you and the doctor, or one-way dialogue with the doctor speaking mostly to you?
7.Approximately how many different medications do you take daily to manage/treat your Alport syndrome? (This can include dialysis or transplant-related medications as well, if applicable).
8.Have you ever experienced side effects from your Alport syndrome treatment medications?
9.Please check all side effects you may experience from Alport syndrome treatment medications.
10.Check all topics your nephrologist has asked you about during a visit/check-up.