Below is a list of the currently available questionnaires/surveys.  Please note, registration is required to be able to stop and later resume a given questionnaire.  Those who tolerated fluoroquinolones (control subjects) are not required to register, and can take the control survey in one sitting.

As more questionnaires/surveys become available, links to the questionnaires along with their dates added will appear on this page.

Registration:

1. Those who believe they have tolerated fluoroquinolones may directly complete the control survey via the link below.  Those who believe that they have experienced side effects are required to register for surveys first.  Within a few days of registering, you will receive a personalized link to each individual survey via email.  Each link enables one to stop the survey at any time and later resume from the screen where they left off.  Those who believe they have tolerated fluoroquinolones may also choose to register if wishing to be able to take a break and later resume the survey.  Once a particular survey has been started,  it may be resumed for up to 2 weeks.  Please remember that the more complete the information provided in responses, the more accurate the results and the more likely the study is to identify rare and previously unidentified risk factors and effects.
   

1. Register for the surveys by clicking here
   

For Fluoroquinolone Adverse Reaction Sufferers:

1. These questionnaires are for those who believe that they have suffered an adverse reaction to fluoroquinolone antibiotics during and/or after cessation.
   

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3. •Questionnaire 1 - Risk Factors and Symptom Progression
   

4. Covers: History and dates of fluoroquinolone use, adverse effects, and their progression.
   

5. Expected duration: 40-90 minutes.
   

6. Date added: 2013-11-13.
   

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8. Note: This questionnaire will ask about fluoroquinolones you’ve taken and the dates they were taken.  If you request this information from your pharmacy *before* performing the survey, it should speed up the survey process and make our results more accurate.
   

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10. •Questionnaire 2 - Life and Career Impacts
    

11. Covers: Effects on personal life, family, and career.
    

12. Expected duration: 30-60 minutes.
    

13. Date added: 2013-11-13.
    

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15. •Questionnaire 3 - Personal Narrative
    

16. Covers: Open ended form for describing personal story.
    

17. Expected duration: 10-60 minutes.
    

18. Date added: 2013-11-13.
    

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20. Register for these surveys by clicking here
    

For Control Subjects:

1. These questionnaires are for those who have taken fluoroquinolone antibiotics and believe that they have tolerated them without suffering side effects or any adverse reaction.
   

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3. •Questionnaire C1 - Control Survey
   

4. Covers: History and dates of fluoroquinolone use for those tolerating fluoroquinolones.
   

5. Expected duration: 20-30 minutes.
   

6. Date added: 2013-11-13.
   

1. Note: This questionnaire will ask about fluoroquinolones you’ve taken and the dates they were taken.  If you request this information from your pharmacy *before* performing the survey, it should speed up the survey process and make our results more accurate.
   

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3. Start the control questionnaire now by clicking here
   

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