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. 2020 Aug 6;4(5):950–957. doi: 10.1002/jgh3.12396

Table 1.

Patient survey questions

Question Options
What is your age?
What is your gender?
  1. Male

  2. Female

What date was your FMT?
How was your FMT delivered?
  1. Via colonoscopy

  2. Via endoscopy

  3. Naso‐jejunal tube

  4. Enemas

Had you heard of FMT prior to developing Clostridium difficile infection?
  1. Yes

  2. No

How did you first hear of FMT as a treatment?
  1. Treating specialist

  2. General practitioner

  3. Media

  4. Friend

  5. Other

What was your perception of FMT when first discussed with your doctor as a treatment for your C. difficile?
  1. I had no concerns, I just wanted to get better I was concerned about:

  2. the “yuck” factor

  3. infection risk

  4. contracting other disease

  5. the colonoscopy

  6. other

Did this perception change after FMT?
  1. Yes

  2. No

If yes, how?

Would you recommend FMT to other patients with CDI?
  1. Yes

  2. No

How many relapses did you have prior to FMT?
Have you had a relapse since FMT?
  1. Yes

  2. No

If yes, how was this treated?

How long did it take for symptoms to resolve after FMT?
  1. Days

  2. Weeks

  3. Months

  4. I have ongoing symptoms

Have you developed any new diseases or symptoms following FMT?
  1. Yes

  2. No

If yes, describe

Have you noticed improvement in any other medical conditions after FMT?
  1. Yes

  2. No

If yes, describe

Are you concerned about infection risk from FMT?
  1. Yes

  2. No

Are you satisfied with your treatment outcome?
  1. Yes

  2. No

Who do you believe would be an ideal donor?
  1. Spouse

  2. Sibling

  3. Friend or unrelated contact

  4. Anonymous screened donor

Do you think a third party (i.e. Medicare, private insurance or state government) should subsidise the costs to patients for recurrent or refractory FMT?
  1. Yes

  2. No

In your opinion, should FMT be classified as:
  1. Bodily tissue donation

  2. Therapeutic drug

  3. Unsure

CDI, Clostridioides difficile infection; FMT, fecal microbiota transplantation.