Exit this survey Acne Prequalification Survey To determine if you pre-qualify for this facial acne (pimples) research study, we will ask you a few questions. You may stop answering at any time and do not need to answer any questions that make you feel uncomfortable. All information you provide will be kept confidential and will not be shared without your permission or unless required by law. Question Title * 1. Please tell us about yourself. Name: Address: City/Town: State: -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP: Email Address: Phone Number: Question Title * 2. This acne research study is for people between the ages of 12-40 years. Please let us know if you are 18 years of age or older: Yes No (if no, have a parent or guardian complete the survey for you) Question Title * 3. Please write your initials Question Title * 4. If female, are you pregnant or planning a pregnancy or currently breastfeeding? Yes No N/A - Male Question Title * 5. Do you have mild to severe acne on your face? Yes No Question Title * 6. Have you participated in another clinical research study in the past month? Yes No Question Title * 7. How did you hear about this study? Internet - Facebook/Instagram Craigslist Acne Website VIa Search Engine Friend/Family Other (please specify) Thank you for your answers. We will review your information and contact you only if you are identified as a potential candidate for this trial. Done