Tell Us How You Feel

Your feedback is valuable to us. Please use the form blow to share your Limbrel experience or to submit any requests or questions. If you have had or are having an adverse event to Limbrel, contact your physician immediately and report it to Primus using the form below.

First Name *   Last Name *
Address
City    State    Zip
Email *   Telephone
Age
The Limbrel I am currently taking is: *




How can I find out which one I am taking?
Find it on your pharmacy label, OR look at the number imprinted on each capsule: 52001 is 250mg, 52002 is 500mg, 52005 is 250mg/50mg, and 52006 is 500mg/50mg

How many weeks have you been using Limbrel?   (Enter 0, if you have not used Limbrel)

How did you hear about Limbrel (check all that apply)?
Physician Physician’s Assistant Nurse Practitioner
Pharmacist Family Member Friend
Internet Advertisement Article or Interview
Other: (please write in)
Type of feedback (check one):
Feedback &
Comments		 Question Product
Complaint		 Product
Praise
Tell us how it feels to live with your
condition before you tried Limbrel
Tell us how it feels after
you have tried Limbrel
Which improvement did you notice first after taking Limbrel?
(please check one, or write in others)
Less Morning Stiffness Less Stiffness in General Improved Mobility in General Less Joint Discomfort
in General
Other Improvement(s)
How soon did you notice the above improvement after taking Limbrel?
(please check one)
1st day 2-3 days 4-5 days 6-7 days
8-9 days 10+ days
Which Limbrel strength were you taking when you noticed the above improvement?
(please check one)
250 mg
1 time a day		 250 mg
2 times a day		 250 mg
3 times a day
500 mg
1 time a day		 500 mg
2 times a day		 500 mg
3 times a day
Other Feedback or Question

My physician who prescribed Limbrel to me (or please contact my physician about Limbrel):
First Name Last Name Specialty
Address You have my permission to
contact my doctor listed here
regarding my feedback:
YES
NO
City      State      Zip
Phone Fax

Survey Follow-up (check all that apply):
Please do not contact me in the future
Please contact me to discuss my feedback on Limbrel
Please provide more Limbrel information to me
Please email someone I know with Osteoarthritis Limbrel information
The names and email addresses or phone numbers of my friends to contact are as follows:
Name Email Phone
 *Required Field