Norco Side Effect Survey

Hello! We just wanted to check-in regarding side effects with your prescription for Norco (Hydrocodone with Acetaminophen).

Name

First Name

Last Name

Phone Number

Are you experiencing any of the following side effects? (Check all that apply)

I am not experiencing side effects

Drowsiness / Sedation

Mood changes

Constipation

Other

If other, please share more details

How severe are your symptoms?

Is there anything more you would like to share?