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* First Name
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* Please indicate your professional title (select one):
Physician
Nurse Practitioner
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If Other, please specify:
* Please indicate your specialty (select one):
Pediatrics
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If Other, please indicate:
* Please indicate years of practice in specialty:
Approximately how many patients with atopic dermatitis do you see per week?
Please complete a brief preprogram survey. The faculty will use your responses to better address your interests and challenges in managing patients with atopic dermatitis.
1. On average, what percentage of your patients with atopic dermatitis do you refer to a specialist for treatment?
2. On average, after how many visits do you refer your patients with atopic dermatitis to a specialist for treatment?
3. What is the greatest challenge you have experienced related to the diagnosis or management of atopic dermatitis?
4. Using a scale where 5=always and 1=never, rate how often you provide patients with a written action plan for managing their atopic dermatitis.
5 - always
4 - very often
3 - sometimes
2 - rarely
1 - never
5. Using a scale where 5=always and 1=never, rate how often you ask your patients with atopic dermatitis about their quality of concerns (eg, sleep, itching).
5 - always
4 - very often
3 - sometimes
2 - rarely
1 - never
6. Using a scale where 5=always and 1=never, rate how often you use daily moisturizing for managing atopic dermatitis.
5 - always
4 - very often
3 - sometimes
2 - rarely
1 - never
7. Using a scale where 5=always and 1=never, rate how often you use dilute bleach baths for managing atopic dermatitis.
5 - always
4 - very often
3 - sometimes
2 - rarely
1 - never
8. Using a scale where 5=always and 1=never, rate how often you use intermittent topical corticosteroids between flares for managing atopic dermatitis.
5 - always
4 - very often
3 - sometimes
2 - rarely
1 - never
9. Using a scale where 5=always and 1=never, rate how often you use food-elimination diets for managing atopic dermatitis.
5 - always
4 - very often
3 - sometimes
2 - rarely
1 - never
 
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