Got Acne? You may qualify for a research study. 

Below is a pre-screening survey to help us determine your qualification in one of our studies. You may stop the survey at anytime. All information provided is confidential. 

* 1. What is your first name?

* 2. What is your last name?

* 3. Phone Number:

* 4. Email: 

* 5. If female, are you pregnant or planning a pregnancy or nursing?

* 6. How would you rate the severity of your acne?

* 7. On average, how many acne lesions (red or raised pimples) do you have on your face?

* 8. How many blackheads and/or whiteheads do you have on your face?

* 9. Which therapies are you currently using for your acne?

* 10. Have you participated in another clinical research study in the past two months?

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