Questionnaire Part I. Personal Profile Direction: Kindly check () or supply with the accurate information about yourself. 1.

Age __________ 2. Gender: ( ) Male ( ) Female

3. Employment Status ( ) Employed 4. Familys Monthly Income ( ) 100 000 and above ( ) 50 000 100 000 ( ) 15 000 50 000 ( ) 8 000 15 000 ( ) 8 000 and below ( ) Unemployed ( ) Underemployed

Part II. Level of Awareness and Compliance in Tuberculosis Directly Observed Treatment Shortcourse (DOTS) Program 1. For which symptom(s) did you contact the health center? ___Persistent cough ___fever ___chest pain Others, please specify ________________ 2. What did you do for the symptom(s)? a) Thought it was a simple cough and did not seek any medical attention b) Consulted the health center physician and took medicines for cough and fever c) Got scared that it might be Tuberculosis and told family members d) Was aware of the symptoms of Tuberculosis and hence consulted at the health center 3. Who advised you to go to the Health Center? a) Came on your own b) Government Hospital/ Dispensary c) Private Doctor d) Member of the family and/or relatives ___low appetite ___weight loss ___blood in cough

4. Are you aware of the kind of Tuberculosis you have? ___Yes ___ No

If Yes, which kind? ___________________________________________________ 5. Do you know the reasons behind your illness? ___ Due to lifestyle ___Hereditary ___Unaware ___Direct contact from others with TB

6. Do you sit and eat with your family members? ___Yes ___No

If No, why ___________________________________________________________ 8. Do you feel that TB can be totally cured? ___Yes ___No

If No, why ____________________________________________________________ 9. Do you have any problems coming to the Health Center for medication? ___Yes ___No

If Yes, why ____________________________________________________________ 10. Are you given assistance and supervision when you go to the health center for treatment? ___Yes ___No

11. Are you given continuous health education regarding the treatment regimen? ___Yes ___No

12. Are you given complete set of TB Medications every time you go the health center for treatment? ___Yes ___No

13. Under what Category of DOTS Treatment Course do you belong? a) Category I (New in the treatment course) b) Category II (Those who failed to complete a treatment course and returned after default) c) Category III (Those with new smear -negative PTB with minimal lesions on Chest Xray) d) Category IV (Those who are sill smear-positive after supervised retreatment

14. How long have you been treated for TB? _____________________________ 15. Have you ever failed completing the duration of treatment course? ___Yes ___No