1. I've had arthritis for: years. 2. My arthritis is:  severe  moderate  mild 3. I have a history of stomach ulcer.  yes  no 4. I am under the care of these doctors and specialists:  family practice/primary care  internist  cardiologist  rheumatologist  gastroenterologist  endocrinologist  other 5. I am currently taking the following prescription medications: 6. I also take these over-the-counter medications or supplements: 7. I take low-dose or baby aspirin.  yes  no

TAP Pharmaceutical Products Inc. respects your privacy. Any information you enter will only be used for the purposes of this Doctor Discussion Guide and will not be sent to or retained by TAP in any form.