Items:

1. I feel confident in asking the doctor questions about my illness.
2. I feel confident in asking the doctor questions about my medication.
3. I feel confident in asking the doctor questions about my treatment.
4. I feel confident in asking the doctor to repeat information.
5. I feel confident in telling the doctor that I did not understand what was said about my illness.
6. I feel confident in telling the doctor that I did not understand how to take my medication.
7. I feel confident in asking the doctor to explain the purpose of medical tests.
8. I feel confident in questioning the doctor’s advice\recommendation.
9. I feel confident in telling the doctor that I have had side-effects from the medication.
10. I feel confident in telling the doctor that I have not followed his\her recommendations.
11. I feel confident in telling the doctor I want to change my medication.

Response Options:
7 point scale of agreement
Not at all true - 1
Somewhat true - 3
Very true - 7