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Please take a moment to fill out this brief survey about your most recent experience using the InstyMeds Prescription Medication Dispenser.

We value your input!

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* 1. What health care facility did you use the InstyMeds dispenser at?

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* 2. Please provide the following information about yourself

  Gender
Your gender:

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* 3. Please provide the following information about yourself

  Age
Your age:

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* 4. Please provide the following information about yourself

  Number
Number of children:

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* 5. Please provide the following information about yourself

  Number
Number of children with you at the time of using InstyMeds:

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* 6. Did you use InstyMeds to get a medication for yourself or a family member?

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* 7. How likely is it that you would recommend InstyMeds to a friend or colleague?

Not at all likely
Extremely likely

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* 8. Would you utilize mail order services for your medications if they were available?

T