We are conducting a survey about the use of herbal medicine in adults. Please answer the following questions that describes you best. We are very grateful to you for finding the time to fill in this survey.

* 1. What is your gender?

* 2. What is your age?

* 3. What is your occupation?

* 4. What is your marital status?

* 5. Do you believe in the healing power of plants?

* 6. Do you recognise drinking herbal teas as medicinal?

If you drink herbal teas please accept these as taking medicinal plants and include them when answering the following questions.

Medicinal plants include plants/herbs taken in the form of herbal teas, capsules, tinctures, fluid extracts, oils, powders, dried, fresh or juiced

* 7. Have you used medicinal plants for:

* 8. How frequently have you used medicinal plants over the last 12 months:

* 9. How did you decide on the dose and how long to take it for?

* 10. Have you informed your medical doctor about using medicinal plants?

* 11. If you answered yes to the question above, what was your medical doctors reaction:

* 12. Please tell us what you think

  Yes No Don't know
I feel uncomfortable using herbs
I am accustomed to using herbs
Plants work better than pills
Herbs are safe
Herbs have less side effects
Doctors or pills can't make me cure my illness
Cheaper using herbs
Easier to access herbs than medicines

* 13. Have you received information about medicinal plants from:

* 14. Have you been unwell over the last 12 months?

* 15. If unwell, how long have you been unwell?

* 16. If unwell, what type of illness did you have:

* 17. Who did you consult when unwell?

* 18. Did you use:

* 19. If you took herbs whilst on prescription medicine did you check it was safe to mix?

* 20. Would you consider growing your own herbs?

* 22. Please tell us for what medicinal purposes you used any of the above herbs?

* 23. I would like to be entered to the prize draw to receive a free visit to the Dilston Herbal Garden in Northumberland. Please enter your email below.

Thank you for participating in our survey.