HCP Channel Questionnaire - Oct2013

We have your name on our database as having returned a warranty card for a blood glucose monitor from Bayer. In order to help us provide you with more information about our complimentary support service and check you are up and running with your meter we would very much appreciate it if you could fill in this short survey. This will only take up about 3 to 4 minutes of your time.

Please be advised that we will be making a record of your responses.

Please confirm your details

First Name :
Last Name :
* Email Address :

* Which Bayer meter did you receive from us?

* How did you first receive your meter?

Was given to me by GP

Was given to me at the hospital

Was given to me by diabetes nurse

* Are you still using the Bayer meter?

Yes

No

* Do you use the Bayer meter as your main meter?

Yes

No

* Do you intend using this as your main meter in the foreseeable future?

Yes

No

Maybe

* Why?

* Using the Bayer meter how often are you testing your blood glucose?

1-3 times per week

4-6 times per week

7-9 times per week

10-14 times per week

15-19 times per week

20-24 times per week

25-29 times per week

30+ times per week

* Has the usage of your Bayer meter increased or decreased since you first received your Bayer meter?

Increased

Decreased

Remains the same

* Usage has increased because:

Change in condition made me decide to test more

Change in recommendation from the healthcare professional team

Change of use of Bayer meter as the primary meter

Other

* Usage has decreased because:

Improved medical condition made me decide to test less

Restriction of use from the healthcare professional team

Use of other competitor meter as primary meter

Other

* How long did you use the Bayer meter before stopping the use of the meter?

* Why didn’t you use the meter or stop so quickly?

I didn't know how to use it

I was not able to get strips for this meter

Other

* If you were not able to get strips for this meter at the beginning please tell us why?

GP Practice will not allow these on my prescription

Not able to get strips for new meter as local pharmacy hasn’t got them

Other

* Why did you stop using the meter?

I am not able to get strips for this meter anymore

I am not testing my blood glucose anymore

I prefer to use a different meter

Other

* If you were not able to get strips for this meter please tell us why?

GP Practice will not allow these on my prescription

Not able to get strips for new meter as local pharmacy hasn’t got them

Other

* Which meter do you currently use?

* Bayer plc would like to contact you via email to provide you with useful information regarding your diabetes and keep you informed about Bayer products and offers. Do you give permission?

Yes

No

* Bayer plc would like to contact you via email to provide you with useful information regarding your diabetes and keep you informed about Bayer products and offers. Do you give permission?

Yes

No