Question Title

* 1. Having AK has had an impact on my life:

Question Title

* 2. If you agree or strongly agree that AK has had an impact, please select which areas of your life it affects or has affected (select all that apply):

Question Title

* 3. Please use the following space to provide any relevant examples of how AK has impacted your life (e.g., if you were worried, do you still continue to worry? If you missed work, how many days did you miss, what type of family activities did you miss out on?

Question Title

* 4. I am concerned about an AK spot progressing into a more serious form of skin cancer if it goes untreated:

Question Title

* 5. I am concerned that skin cancer could lead to:

Question Title

* 6. Have you had treatment for an AK spot or are you currently using a treatment?

Question Title

* 7. If you answered 'yes' to the last question, please describe the treatment(s):

Question Title

* 8. If prescribed a topical treatment, how long was the course of treatment?

Question Title

* 9. Were you able to continue on this topical treatment for the full course as directed by your doctor? If no, why not (check all that apply).

Question Title

* 10. If you checked "I experienced side effects" or "I was worried about scarring" in the question above, please describe the skin reactions you experienced from the topical treatment:

  not at all a little a lot
Redness
Itching
Scaling
Scarring
Skin pigmentation changes

Question Title

* 11. What if anything did you use to manage any reactions you might have experienced?

Question Title

* 12. To what degree did / do the side effects of treatment affect your daily living?

Question Title

* 13. If you selected 'somewhat' or 'significantly' to question 11, please select which areas of your life were affected by the effects of the treatment (select all that apply):

Question Title

* 14. Please use the following space to provide examples (e.g., how many work days you missed, what type of family activities you missed, how you were affected by scaring, etc.)

Question Title

* 15. What benefits, reduced side effects or other features would you hope to see in a new treatment that previous treatment(s) you've tried did not offer?

T