This survey is open to and intended for anyone under treatment for hypothyroidism.

This questionnaire was prepared by a physician panel that is organizing a symposium on hypothyroidism treatment to be held in the Spring of 2017 in Orlando, Florida, USA. Anyone with hypothyroidism who is taking thyroid hormone is encouraged to take this survey, feel free to disseminate this survey link broadly, and encourage others to take the survey. We also encourage all thyroid healthcare professionals to share this survey with their patients.

The results will be compiled by the ATA and discussed during the symposium with a group of three non-physicians affected by hypothyroidism. Subsequently the results will be posted online with free access to the public.  Your responses will be anonymous.The survey is intended to enhance understanding and treatment of hypothyroidism and should only take up to 7 minutes to complete. 

The ATA is the leading organization devoted to thyroid biology and to the prevention and treatment of thyroid disease through excellence in research, clinical care, education and public health. Additional information regarding the ATA may be found our website at www.thyroid.org.

Additional information regarding the ATA may be found our website at www.thyroid.org.

We appreciate your feedback and look forward to your responses.


* 1. Are you taking thyroid hormone for hypothyroidism?

* 2. What thyroid hormone are you currently taking?

* 3. How satisfied are you with the treatment you receive? (Please select the number the best represents your satisfaction level.)

* 4. If you are not satisfied with the treatment you receive, please indicate any relevant areas you feel are affected by your thyroid treatment and could improve: (Please check all that apply.)

* 5. How satisfied are you with your current physician who treats you for your thyroid condition? (Please select the number the best represents your satisfaction level.)

* 6. How knowledgeable do you believe your doctor and/or physicians in general are about treatment of hypothyroidism? (Please select the number the best represents your answer.)

* 7. How many times have you changed doctors because you were not satisfied with the hypothyroidism treatment you were receiving?

* 8. Have you ever tried any alternative form of hypothyroidism treatment - not prescribed by your doctor - based on a friend’s advice, supermarket or internet?

* 9. How would you rate the need for new treatments for hypothyroidism? (Please select the number the best represents your answer.)

* 10. How has your life, or the life of someone you love, been affected by your hypothyroidism? (Please select the number the best represents your answer.)

* 11. Do you think that any causes not related to thyroid hormone levels could be contributing to your symptoms? (Please check all that apply)

* 12. Do you have any of these medical problems? (please check all that apply)

* 13. Please tell us your gender.

* 14. Please tell us your age.

* 15. What is the cause of your hypothyroidism?

* 16. How long have you been treated for hypothyroidism?

* 17. What is your postal / zip code?

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