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. 

What is your first name?

Question Title

* 1. What is your first name?

What is your last name?

Question Title

* 2. What is your last name?

Phone Number:

Question Title

* 3. Phone Number:

Email: 

Question Title

* 4. Email: 

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

Question Title

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

How would you rate the severity of your acne?

Question Title

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

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

Question Title

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

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

Question Title

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

Which therapies are you currently using for your acne?

Question Title

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

Have you participated in another clinical research study in the past 30 days?

Question Title

* 10. Have you participated in another clinical research study in the past 30 days?

T