QUESTIONNAIRE NameAgeSexEducationContact detailsProfession___________________________________________________________________________ 1. How often do you visit chemist?

Weekly Fortnight Monthly Other - ____________

Arrange the following indications of self-medication in the order of frequency of occurrence to you. 1.Headache 2.cough/cold 3.flu 4.Throath infection 5.stomach infection 6.fever 7.others (specify)

Please describe among the following reasons for self medication a. Time saving b. No need to consult doctor for minor illness c. economical (save money) d. no doctor is nearby e. conveience Please give the sources of information regarding self medication A) B) C) D) E) Friends Pharmacist Doctors previous prescription TV./Radio advertisement Books/ internet

Who uses the medication brought without prescription A) B) C) D) Yourself Family members Both of above Others (Friends/neighbours)

Have you been asked about the medical priscription at the chemist A) B) C) Yes No Sometimes

Do you think that buying and using medication without consulting doctor or physician may lead to complications? Yes No

What do you prefer for following? FEVER (a) (b) (c) (d) Crocin Combiflame Nemisulide Others

2. Do you often visit the same chemist? Yes No

3. Do you take doctors prescription or self-medication? Doctors prescription Self-medication 4. Do you visit the doctor at first sight of illness? Yes No Sometimes 5. What do you prefer to treat your illness? Allopathic Ayurvedic Homeopathy Others

6. Do you rely on chemists suggestion for your illness? Always Sometimes Never

7. Will you accept substitutes given by chemist for prescribed medicines given by doctor? Sometimes Never Cant say 8. Will you go for a less expensive medicine of same composition if your chemist suggests? Always Sometimes Never Please give your comments on the following statements Non-prescription medicines are totally same to use? Strongly agree Agree Unsure Disagree Strongly disagree

9.

10. Some OTC products can interfere with natural healing process? Strongly agree Agree Unsure Disagree Strongly disagree What do you prefer for following? 11 HEADACHE

(A) (B) (C) (D) (E) (F) (G)

SARIDON Relispray Iodex balm Zandu balm Moov Voveran tablet Calpol

12) COUGH (a) Vicks (b) Corex (c) Benadryl (d) Phensedyl 13 ) COLD (a) Sinarest (b) Crocin-cold and flu (c) D-cold (d) Vicks action 500 (e) CTZ

14 ) DIGESTIVE HEALTH (a) Eno (b) Hajmola (c) Pudinhara (d) Digene (e) Omez 15 ) VITAMINS MINERALS SUPPLEMENTS (a) Dexorange (b) Becosules (c) Shelcal (d) Raintak (e) Supradin 16) Who influences you the most for the choice of OTC medicines Doctors Pharmacists Friends and family Advertisement Past experience Others-_____________