Medication survey

Full medication structure restored from the original PHP page

The historical form tracked daily totals for levodopa, decarboxylase inhibitors, COMT inhibitors, dopamine agonists, MAO-B inhibitors, and anticholinergics. The rebuilt page keeps that logic, but makes the form much easier to read and save.

1. Are you currently taking medication for Parkinson's?

Yes No

2. Start month for this dose pattern

Start year

All values below are daily totals in mg. If you are unsure whether a formulation is IR or CR, enter it in IR.

Other Parkinson's drugs or notes (max 200 characters)

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Why this form is much larger now

The old PHP questionnaire was not just a free-text medication note. It captured a whole matrix of drug classes and IR/CR doses, which then powered the public CSV export and the old statistics page. This rebuilt version restores that structure.