Patient questionnaire

	Yes	No	Uncertain
1. I am taking or being given medicines (other than through a drip) while in hospital. If No go to question 7	□	□	□
2. I know that some patients are able to keep and administer their own medicines in this hospital.	□	□	□
3. I have seen a leaflet about self-administration during this stay in hospital.	□	□	□
4. I have kept and administered my own medicines during this stay in hospital. If No go to question 6	□	□	□
5. The nurses know that I keep and administer my own medicines during this stay in hospital.	□	□	□
6. I would like to keep and administer my own medicines during this stay in hospital if I am able to.	□	□	□
7. I have kept and administered my own medication during previous visits to hospital.	□	□	□