Question Grid

Name

qg_B1_za-zd

Label

B1 za-zd

Question Text

Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months.

Yes in past 12 months If yes, give name of substance How often did you take/use this?
Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)

Usage

30 questions before...
Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months.
Yes in past 12 months If yes, give name of substance 1 If yes, give name of substance 2 How often did you take/use this? 1 How often did you take/use this? 2

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Headache or or migraine
Backache
Groin pain
Other pain
Indigestion
Nausea
Vomiting
Diarrhoea
Piles or haemorrhoids
Constipation
Depression
Anxiety or nerves
Sleeping
Psoriasis
Eczema
Asthma
Hay fever
Other allergies
Sore throat
Cough
A cold
Flu
Other infection
Diabetes
Epilepsy
High blood pressure
Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months.
Yes in past 12 months If yes, give name of substance How often did you take/use this?
Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text
Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)

Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months. Took no medicines, pills, drops or ointment

1
Yes
65 questions after...
View the complete questionnaire

Dimensions

Code Dimension

Display Code
False
Display Label
False

Code Dimension

Display Code
False
Display Label
False

Response Options

Type
Text
Maximum Length
255
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
1
Type
Code List
Selection Style
SelectOne
Codes
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
2
Type
Code List
Selection Style
SelectOne
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
3
Type
Text
Maximum Length
255
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
4
Type
Code List
Selection Style
SelectOne
Codes
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
5
Type
Code List
Selection Style
SelectOne
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
6
Type
Code List
Selection Style
SelectOne
Codes
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
7
Type
Code List
Selection Style
SelectOne
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
8
Type
Text
Maximum Length
255
Rank
1
All Values
True
Rank
2
All Values
False
Specific Value
9