Treatment Questions | Pharma Aesthetics

Answer medical questions to order

Have you read the eczema medical information?

Yes No

Is the Eczema on the face

Yes No

Have you been diagnosed with eczema by a GP or skin specialist?

Yes No

If you have a rash that is new or undiagnosed it is best to see a doctor.

Have you been prescribed steroid skin treatment in the past?

Yes No

Are you aware you should see a doctor about new rashes, worsening rashes, and rashes not responding to treatment?

Yes No

Are you aware paraffin containing preparations (emollients and steroid creams and ointments) can soak into clothing and bedding and cause a fire hazard?

Yes No

Wash clothing and bedding frequently Avoid smoking and naked flames.

Are you aware that long-term use of steroid creams and ointments can cause permanent skin damage and skin thinning?

Yes No

Are you aware that eczema should always be treated with frequent emollients even if using steroid creams or ointments?

Yes No

Are you pregnant or breastfeeding?

Yes No

Do you have any further medical information or questions?

Yes No

Is there anything you do not understand or do you need further help?

Do all the following apply to you?

Yes No

The medication is for my own use and I will not share with anyone else I will read the patient information leaflet supplied with the medicine pack I am over 18 and I agree to identity verification checks I have completed this questionnaire myself and fully understand all the information My responses are honest and accurate, and I understand that this is necessary for a safe medical assessment I agree to the terms & conditions, privacy policy, data sharing policy & consent to cookies

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Eczema

Answer medical questions to order

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