Do I Qualify
Do I Qualify

Clinical Trial for Atopic Dermatitis

There’s No Obligation

Completing the online screener does NOT obligate you to participate in the trial. If your health history is a match for trial requirements, you will be contacted by a trial representative (only if you grant permission). Study representatives may contact you by telephone, email, or text.

Yes

No

*This is a required field.
Atopic Dermatitis (eczema) is a condition that makes the skin red and itchy due to genetics and environmental factors. It is a chronic condition, but symptoms tend to flare (come and go) and include rash, flakiness, and itching.

Yes

No

Unsure

*This is a required field.
  • Itchy skin
  • Patches of skin that are light red to dark red in color
  • Visible papules
  • Thickened skin
  • Oozing or crusting of the skin
 

Yes

No

Unsure

*This is a required field.
*This is a required field.

Yes

No

Unsure

*This is a required field.

Yes

No

*This is a required field.

Bone marrow transplant

Cancer diagnosis in the last 5 years

None of the above

*This is a required field.

I am currently pregnant

I am currently breastfeeding

None of the above

Not Applicable

*This is a required field.
Why are we asking this question? We are collecting this information in an effort to monitor if our patient recruitment materials reach a diverse audience as part of our effort to increase diverse representation in our clinical trials. Diverse, inclusive trials are critical to understanding how certain patient populations may respond to a particular treatment or medicine. They also help to identify and address unique circumstances that may arise in different patient populations while on therapy or taking a medication. Your race or ethnic group does not determine eligibility for the trial.

White

Black / African American

Asian

American Indian or Alaska Native

Native Hawaiian or Pacific Islander

Other

I don’t want to answer

*This is a required field.
Why are we asking this question? We are collecting this information in an effort to monitor if our patient recruitment materials reach a diverse audience as part of our effort to increase diverse representation in our clinical trials. Diverse, inclusive trials are critical to understanding how certain patient populations may respond to a particular treatment or medicine. They also help to identify and address unique circumstances that may arise in different patient populations while on therapy or taking a medication. Your race or ethnic group does not determine eligibility for the trial.

Hispanic or Latino

Not Hispanic or Latino

Unknown

I don’t want to answer

*This is a required field.
Clinical trials are normally run in hospitals or clinics and may require visits. By providing a location, we’ll help you find trial sites that are closest to you.
*This is a required field.