FIP Side Effects Pictogram Survey Paper version
FIP Side Effects Pictogram Survey Paper version
FIP Side Effects Pictogram Survey Paper version
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3.<br />
4.<br />
5.<br />
6.<br />
Participant Information<br />
Which country is your current residence?<br />
• _________________________________________<br />
In which country were you born?<br />
• _________________________________________<br />
What is your age group? (Circle One)<br />
• 11‐15 years old<br />
• 16‐20 years old<br />
• 21‐30 years old<br />
• 31‐40 years old<br />
• 41‐50 years old<br />
• 51‐60 years old<br />
• 61‐70 years old<br />
• Greater than 70 years old<br />
What is your gender? (Circle One)<br />
• Male<br />
• Female
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