Information Gathering Survey
The purpose of this survey is to collect patient data pertaining to current Solu-cortef usage trends and assess interest in a Solu-cortef auto-injector medical device.

As an industrial design graduate student attending Thomas Jefferson University and a young woman with CAH, I am the co-founder and lead designer for SOLUtion Medical LLC. Simple saves lives. This is what we envision for SOLUtion, our reconstituting autoinjector. SOLUtion’s twist-to-mix intuitive design affords users efficient and reliable life-saving care and reclaimed confidence in times of adrenal crises.
Did you fill out the first survey that was focused on CAH? *
Do your responses to this survey come as a: *
What type of Adrenal Insufficiency does this person have? *
How old is this person? *
Your answer
How old was this person when diagnosed? *
Your answer
What is this person's gender? *
Has this person needed an injection of solu-cortef? *
Who injected this person? *
How old was this person when the first injection was needed? *
Your answer
Can you please describe the circumstances surrounding this first event? *
Your answer
If you are filling this out for more than one person please add their details below (type of AI, age, gender (if desired) who injected etc. *
Your answer
Describe any addition times an injection of solu-cortef has been needed? *
Your answer
What aspects of the current Solu-Cortef Act-o-vial medication injection process do you find helpful? *
Your answer
What aspects of the current Solu-Cortef Act-o-vial medication injection process do you find frustrating? *
Your answer
How would you like to see the process for administering Solu-cortef in adrenal crisis situations improved? *
Your answer
How much do you pay out of pocket for a Solu-cortef act-o-vial? *
Your answer
Has a pharmacy ever provided you with the incorrect medication for you / your child / anyone you know living with adrenal insufficiency? For example, pharmacies sometimes accidentally dispense powdered cortef to patients instead of the act-o-vial. *
Can you please describe this event?
Your answer
How likely would you be to use a Solu-cortef auto-injector medical device? *
Never
Extremely Likely
How much would you be willing to pay for a Solu-cortef auto-injector device? *
What is the maximum amount you would pay? *
Your answer
Where do you live? (city/state province/country)
Your answer
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