ADD/ADHD Physician Abuse

1. Do you take medication for ADD/ADHD?
• If you answered Yes to question 1 above. Please continue this survey.
• If you answered no to question 1 above, please skip to question number 12

Yes

No

2. Is this medication prescribed to you by a medical professional?

Yes

No

3. Do you take ADD/ADHD medication that is not prescribed to you?

Yes

No

4. What type of medical professional prescribes your ADD/ADHD medication?

a. Pediatrician

b. Family practitioner

c. Clinical psychiatrist (mental health clinician)

d. Nurse practitioner (general)

e. Nurse practitioner (mental health)

f. Walk-in clinic

g. General internist

h. Specialist (non-mental health)

Other

5. Is your prescribing physician located in your home town or by your college?

Yes

No

6. How often do you get your medicine from your physician?

7. Are you satisfied by your medical professional visits?

Yes

No

8. Do you feel that the prescribing medical professional truly cares about your well-being? If Yes, how so? If No leave blank.

9. What type of medication are you on?

10. How often are you prescribed to take it and do you ever take more that you are prescribed?