Questionnaire (unedited)1.

Good day! We, the group 132, section 33 of the Institute of Nursing from the Far Eastern University, are conducting a research entitled “Herbal Medicines versus Pharmaceutical Medicines, which is preferred by mothers?”. We would like to ask for your cooperation in filling up the questionnaire below. Thank you and God bless! Name: (optional) Address:

Age: Contact number:

1. Which of the following herbal medicines are you aware of? Kindly write what the medicine is for. __ Akapulko - __________________ __ Niyog-niyogan - ____________________ __ Ampalaya - __________________ __ Sambong - ____________________ __ Bawang - __________________ __ Tsaang Gubat - ____________________ __ Bayabas - __________________ __ Pancit-pancitan - __________________ _ __ Lagundi - ___________________ __ Peppermint - ____________________ __ Others (Please specify): ________________________________________________________ 2. How often do you: Always a.Use cough medications? (ex. Solmux, Robitussin etc.) b.Use c. d. e. f. g.

Often

Sometimes Never

REFERENCES: http://www.stuartxchange.org/OtherHerbals.html http://www.mixph.com/2008/02/10-herbal-medicines-approved-by-doh.html