Survey Text

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1. During the 2 weeks outlined in red on that calendar, did -- take or use any:

k. Are there any other pills, ointments, or other types of medicines that -- has taken or used during that 2 week period? - Specific
[] Y
[] N

3. Did anyone get a prescription from a doctor for -- to take or use the (medication)?

1[] Y (5)
2[] N

4. Did a doctor recommend that -- take or use the (Medication)?

1[] Y
2[] N