Fulton County
Medication Disposal
Program Evaluation

THANK YOU
for disposing of your unused medication and helping to prevent substance use.
Please help us to improve our program by taking this brief survey.

Question Title

* 1. Did the pouch prompt you to clean out your medicine cabinet?

Yes, I do not clean out my medicine cabinet regularly.

No, I clean out my medicine cabinet on a regular basis.

No, I haven't used the pouch yet. (Please tell us why in the comments below.)

Question Title

* 2. Was the pouch easy to use?

Yes

N/A I haven't used the disposal pouch yet.

Question Title

* 3. What types of medication did you dispose of?

Over the counter (Tylenol, Advil, etc...)

Only Narcotics/Opioids (OxyContin, Percocet, etc...)

Narcotics/Opioids (OxyContin etc) PLUS other medications

Other Prescription Medications (non-narcotic) (Xanax, Wellbutrin, Cialis, etc...)

Vitamins

Not Sure

Question Title

* 4. Where did you receive your medication disposal pouch?

Community Event

Road to Wellness Event

Police Department/Sheriff's Office

Retail Pharmacy

Hospital Pharmacy

Physician's Office

Health Department

Question Title

* 5. Did you know that Fulton County has several 24/7 drug collection boxes?

Yes

Question Title

* 6. What is your zip code?

Question Title

This medication disposal program was developed in partnership with Healthy Choices Caring Community,
Summit County Community Partnership, and funded by Four County ADAMhs Board.