Questionnaire

(Self Medication)

Assalam-o-Alaikum:

We are students of “ College of pharmacy GCUF” and this questionnaire is degsined to study the
“Evaluation of self medication trend” which is the assignment topic.As you are one who can give me the
right information, so I request u to respond honestly, so i my perform my worl efficiently.

Name:_____________________ Age:________________ sex:_______

Qualification:________________ Contact no:__________

Adress:____________________

QUESTIONS

1 What do you think either self medication is incresing or not?

Yes: No:
2 Have u ever done self medication?
Yes: No:
3 If yes then for what kind of problems you use self medications?
Ans:
4 For which age group u do self medication mostly?
o Infaints
o childern
o adults
o geriatrics(old)
5 How u do self medication?
o Using previous prescriptions of the same patient
o Using the prescription of some other patient having same disease
o By using your own knowledge
o Ask some unprofessional(i.e not a physian)
6 For Which of the following u most commanly use as self medication?
o Pian
o Constipation
o Fever
o depression

7 Why people mostly do self medication?

o To save time
o To save money
o Or due to being care less about their health