Do you spend a great deal of time on activities focused on obtaining, using, or recovering from the effects of using ambien?

Do you have strong urges or cravings to take ambien?

Have you experienced relationship or social issues, such as arguments or fights, due to the effects of your ambien use and kept taking it anyway?

Have you used ambien when it was physically hazardous for you to do so, such as while driving your car or operating machinery, or in any other unsafe circumstances?

Do you often take ambien for longer periods of time than you originally intended?

Do you often take ambien in greater quantities than you originally intended?

Have you suffered from a rapid or irregular heartbeat, agitation, or confusion while using Adderall?

Have you often wanted to cut down on your use of ambien?

Have you tried unsuccessfully to cut down on your use of ambien?

Have you failed to meet your responsibilities at home, work, or school, such as experiencing repeated absences or poor performance, because of your ongoing ambien use?

Have you had to reduce or eliminate social or recreational activities due to your ongoing ambien use?

Have you continued to take ambien even when you knew that it was worsening your physical or mental health?

When ceasing prolonged ambien use, have you experienced agitation, anxiety, sweating, a rapid pulse, insomnia, nausea, vomiting, visual or auditory hallucinations, tremors in the hands, or seizures? (Please answer “No” if you are only taking ambien exclusively as directed under medical supervision.)

Have you resumed taking ambien, a similar drug, or alcohol in order to relieve or avoid such symptoms? (Please answer “No” if you are only taking ambien exclusively as directed under medical supervision.)

Have you needed to use greater amounts of ambien to get the desired effect? (Please answer “No” if you are only taking ambien exclusively as directed under medical supervision.)

After using the same dose of ambien for a period of time, have you noticed a lessened effect? (Please answer “No” if you are only taking ambien exclusively as directed under medical supervision.)