Table A4.

How easy it might be for you to use some pharmacy services for your medications and health.

	Strongly Disagree	Disagree	Neutral	Agree	Strongly Agree
1. Enrollment in a program that would schedule all my medications to refill at the same time is up to me.	○	○	○	○	○
2. Participating in Medication Therapy Management (MTM) completely up to me.	○	○	○	○	○
3. I am able to ask my pharmacist to tell me about what Medication Therapy Review (MTR) involves.	○	○	○	○	○
4. I have control over what my medication costs are.	○	○	○	○	○
5. I am able to ask my pharmacist about diabetes education.	○	○	○	○	○
6. If my pharmacist participated in the National Diabetes Prevention Program, I am able to attend classes at the pharmacy.	○	○	○	○	○
7. I am able to talk with my pharmacist about diabetes and heart disease education.	○	○	○	○	○
8. I am able to request a 90-day supply of my medications from the pharmacy.	○	○	○	○	○
9. I am able to request a Medication Therapy Management (MTM) session with my pharmacist.	○	○	○	○	○
10. I am confident I could find out what a Medication Therapy Review (MTR) consists of by asking my pharmacist.	○	○	○	○	○
11. I can ask my pharmacist about ways to lower my medication costs.	○	○	○	○	○
12. I can ask my pharmacist questions about diabetes.	○	○	○	○	○
13. I can look for more information at my pharmacy about the National Diabetes Prevention Program.	○	○	○	○	○
14. I would NOT be able to visit with my pharmacist if I had questions about how I could better manage my diabetes or heart disease.	○	○	○	○	○