Table 1.

The sample of questionnaire

In the name of God
Name:	Family:	Job:	Education level:
job history:	Age:	Address:	gender:
What is the name of your therapeutic method? What are the constituents of your formulation? If you have any type of plants in your formulation please declare the name of plant, parts of used and the time of harvesting and the method of herbal preparation? What is the method of making traditional preparation and storage? What are the application methods? What are the traditional indications of your preparation? Have seen any side effects from this preparation? Does your preparation have any interaction with other chemicals or natural materials? What is your advice for duration of drug application? What are the results of drug application for your formulation? How many people have used this formulation until now? Would the subjects like to use this formulation again?