Pill Glide Survey
TELL US WHAT YOU THINK
Have you ever heard of Pill Glide?
Yes
No
Have you ever heard of FLAVORx?
Yes
No
Which of the following best describes you?
I take care of someone that used/uses Pill Glide.
I tried Pill Glide for myself.
Where did you obtain your Pill Glide?
Why did you try Pill Glide?
Difficulty swallowing tablets/capsules.
Do not like the taste of tablets/capsules.
My child is learning to swallow tablets/capsules.
I am a healthcare provider interested in the product.
It looks like a fun product to try.
Other,
please specify:
In the past 3 months, which of the following types of medications have you taken or given to a patient or child? (check all that apply)
Liquid medication
Oral disintegrating tablets
Chewable tablets
Tablets or capsules
Other,
please specify:
Which of the following has been a barrier when swallowing tablets/capsules. (check all that apply)
Size
Taste
Smell
Texture
Shape
The number of capsules/tablets
No problem swallowing pills
Other,
please specify:
Who have you talked to about difficulty taking or giving medicine? (Check all that apply).
I have not needed to discuss this issue.
Pharmacist
Doctor
Nurse
Other parents/care givers
Family members
No one
Other,
please specify:
What methods have you used to take medicine? (check all that apply).
Mixed with juice
Mixed with flavored syrup
Had pharmacist add flavor
Split or crushed tablet
Masked in food
Have no problems with medicine
Other,
please specify:
Did Pill Glide help you when taking tablets/capsules?
Yes
No
If you answered NO tell us why.
What flavor of Pill Glide did you try?
Grape
Strawberry
Both
Did you or the child like the taste?
Yes
No
If you answered NO tell us why.
How many pumps of spray worked best for you?
Would you use Pill Glide again?
Yes
No
Please provide the year of birth of the person using this product.
Please provide any additional feedback or comments you wish to share.
Can we publish your comments?
Yes
No
If yes, please provide your name, city and state:
