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Table 1 Basic model of the interview form

From: Medicinal plants popularly used in the Xingó region – a semi-arid location in Northeastern Brazil

Name of the person interviewed:   
Date of birth: ____/____/______ Sex: F () M ()  
Schooling: Profession:  
Do you use medicinal plants? Which ones?  
What types of diseases can be treated with these plants?
Which plant parts are used?
() Roots () Stem () Flowers
() Leaves () Bark () Seeds
() Fruits () Entire plant  
How is the medicine prepared?
() Decocted () Tincture () Syrup
() Infusion () Maceration () Other
Municipality: Date:  
Name of the Health Agent: