+31 06 3800 3872
info@huidspecialist.eu
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huidspecialist
Specialist in huidverbetering en huidverzorging.
Succesverhalen
Succesverhalen
Getuigenissen
Voor & Na
Mijn Verhaal
Onderzoek
Wat is je microbioom?
Het geheim van een perfecte huid
Huidallergie-epidemie
Misleiding door natuurlijke cosmetica
Het oplossen van de huidallergie-epidemie
FAQs
Vragenlijst
Which skin problems do you have?
TSW | Pre-program Questionnaire
TSW | Post-program Questionnaire
Business Analysis | Salons
Business Analysis | General
Contact
Menu
Succesverhalen
Succesverhalen
Getuigenissen
Voor & Na
Mijn Verhaal
Onderzoek
Wat is je microbioom?
Het geheim van een perfecte huid
Huidallergie-epidemie
Misleiding door natuurlijke cosmetica
Het oplossen van de huidallergie-epidemie
FAQs
Vragenlijst
Which skin problems do you have?
TSW | Pre-program Questionnaire
TSW | Post-program Questionnaire
Business Analysis | Salons
Business Analysis | General
Contact
Questionnaire
Topical Steroid Withdrawal
Program consultation
Name
Email
How far are you into the skin recovery program?
Can you describe your skin problem/drug/cosmetics history?
Q1: Please list each symptom you were experiencing before starting your recovery plan. Next to each, please also rate their severity from 0-10 (10 being the worst). For example many patients note the most horrible symptoms as deep burning/itching; red and inflamed skin; split skin; oozing; flares; flaking skin; flares; itching attacks; secondary infections; metallic-smelling ooze; elephant skin...
Q2: Please list the same symptoms, and rate their severity from 0-10 now.
Q3: Before starting the plan, roughly how frequently did flares happen? How long did they last? We understand it is variable, so to help, you could describe how many flares you had per month/week/day before starting.
Q4: And roughly how frequently do flares happen now? How long do they last? Please also rate the severity from 0-10.
Q5: Roughly how frequently did itching attacks happen before the plan, and now? Please also rate the severity from 0-10. You can compare the amount of attacks per month/week before the plan to now.
Q6: Please rate your sleep quality from 0-10 (0 being very good and 10 being very bad) before starting the plan, and now. Please include extra details of the average amount of sleep per night if applicable.
Q7: Please describe how the dryness of your skin changed throughout the plan, using 0-10 severity ratings for before, during and now.
Q8: Please describe how your skin felt while applying any products throughout the plan, using 0-10 severity ratings where applicable for during and now.
Q9: Please give details of any other disruptions to your normal life that were caused by TSW before the plan (mental health, social isolation, relationships, work…), and how they have changed now, if at all.
Q10: Please rate your average daily pain (mental and physical) from 0-10 before the plan, and now.
Q11: Please give extra details of *any* changes you’ve noticed. Some patients notice changes in overall health.
Submit Questionnaire
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