Questionnaire - AMR Patients and Family

Please enter your email if you would like us to follow up with you.

Are you a member of a patient organization? *

If so, which one?

Are you aware of the dire consequences of acquiring a drug-resistant infection? *

	Yes, I am aware	Maybe, I know a little	No, I am not aware
What is a drug-resistant infection	Yes, I am awareWhat is a drug-resistant infection Yes, I am aware	Maybe, I know a littleWhat is a drug-resistant infection Maybe, I know a little	No, I am not awareWhat is a drug-resistant infection No, I am not aware
How I can acquire a drug-resistant infection	Yes, I am awareHow I can acquire a drug-resistant infection Yes, I am aware	Maybe, I know a littleHow I can acquire a drug-resistant infection Maybe, I know a little	No, I am not awareHow I can acquire a drug-resistant infection No, I am not aware
How a drug-resistant infection relates to antimicrobial resistance (AMR)	Yes, I am awareHow a drug-resistant infection relates to antimicrobial resistance (AMR) Yes, I am aware	Maybe, I know a littleHow a drug-resistant infection relates to antimicrobial resistance (AMR) Maybe, I know a little	No, I am not awareHow a drug-resistant infection relates to antimicrobial resistance (AMR) No, I am not aware

In the year 2019, have you or a loved one suffered a drug-resistant infection? *

Has your health professional discussed how to best protect yourself from AMR? *

Yes
I don't remember
No

Does your hospital or clinic ensure effective monitoring and surveillance of antimicrobial resistance? *

Yes
Maybe, not sure
No

How do you think we should best spread awareness of antimicrobial resistance (AMR)? *

AMR is the ability of bacteria, viruses, fungi and parasites to resist medicines, causing untreatable infections and increasing the risk of disease spread, severe illness, and death.

If you experience an AMR-related case, are you willing to report and inform us? *

All reporting is kept confidential and all your responses are private.

Additional comments or suggestions *

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Questionnaire – AMR Patients and Family

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