Are you aware that Hydrocortisone Cream should not be used to treat the following skin conditions:
Acne or rosacea
Perioral dermatitis, a type of dermatitis that causes a spotty red rash around the mouth.
Itching around the genitals or anus.
There is no inflammation, but the skin is itchy.
A fungus-related condition such as athlete's foot or thrush.
Virus-related conditions such as cold sores or chickenpox.
Tuberculosis (TB) or syphilis-related skin disorders.

Yes

No

Do you have a history of using Betnovate Scalp Application to treat the same problem?
If you do, how successful was it?

Yes

No

Are you aware that Betnovate should not be used to treat any of the following skin problems:
Acne.
Rosacea.
Perioral dermatitis is a type of dermatitis that affects the area (spotty red rash around your mouth).
Itching or anus around the genitals.
There is no inflammation, but the skin is itchy.

Yes

No

Did you know that Betnovate cream for the face or the front of the neck is not available?

Yes

No

Do you have a history of using (Betnovate) cream/ointment to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Are you aware that Betamethasone with Neomycin Cream should not be used to treat the following skin conditions:
Acne or rosacea
Perioral dermatitis, a type of dermatitis that causes a spotty red rash around the mouth.
Itching around the genitals or anus.
There is no inflammation, but the skin is itchy.
A fungus-related condition such as athlete's foot or thrush.
Virus-related conditions such as cold sores or chickenpox.
Tuberculosis (TB) or syphilis-related skin disorders.

Yes

No

Do you have a history of using Betamethasone with Neomycin Cream cream to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Are you aware that Betamethasone Clioquinol Cream should not be used to treat the following skin conditions:
Acne or rosacea
Perioral dermatitis, a type of dermatitis that causes a spotty red rash around the mouth.
Itching around the genitals or anus.
There is no inflammation, but the skin is itchy.
A fungus-related condition such as athlete's foot or thrush.
Virus-related conditions such as cold sores or chickenpox.
Tuberculosis (TB) or syphilis-related skin disorders.

Yes

No

Does your eczema/dermatitis display any of the following infection symptoms?
Redness.
The area is inflamed or irritated.
The area is quite hot to the touch.
The skin is shattered or leaking.
Do you require assistance?

Yes

No

Do you have a history of using Betamethasone with Clioquinol cream to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Are you aware that betamethasone should not be used to treat any of the following skin problems:
Acne.
Rosacea.
Perioral dermatitis is a type of dermatitis that affects the area (spotty red rash around your mouth).
Itching or anus around the genitals.
There is no inflammation, but the skin is itchy.

Yes

No

Do you have a history of using clobetasone (Eumovate) cream/ointment to treat the same problem?
If you do, when was this and how successful was it?If 'Yes' - Was it effective and how long ago was it?

If 'Not have you attempted any other eczema treatments? If you did, were they successful?

Yes

No

Do you have a history of using Elocon Scalp Lotion to treat the same problem?
If you have, when was it and how successful was it?
If you havent, have you tried any other treatment for the same condition?

Yes

No

Are you the person who will use this medication?
If not, please describe in detail who the intended consumer is and how old he/she is.

Yes

No

Do you have a history of using Hydrocortisone Cream to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Are you aware that Fucidin H Cream should not be used to treat the following skin conditions:
Acne or rosacea
Perioral dermatitis, a type of dermatitis that causes a spotty red rash around the mouth.
Itching around the genitals or anus.
There is no inflammation, but the skin is itchy.
A fungus-related condition such as athlete's foot or thrush.
Virus-related conditions such as cold sores or chickenpox.
Tuberculosis (TB) or syphilis-related skin disorders.

Yes

No

Do you have a history of using Fucidin H cream to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Do you have a history of using Fucidin Cream to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Are you aware that Fucibet Cream should not be used to treat the following skin conditions:
Acne or rosacea
Perioral dermatitis, a type of dermatitis that causes a spotty red rash around the mouth.
Itching around the genitals or anus.
There is no inflammation, but the skin is itchy.
A fungus-related condition such as athlete's foot or thrush.
Virus-related conditions such as cold sores or chickenpox.
Tuberculosis (TB) or syphilis-related skin disorders.

Yes

No

Did you know that Fucibet Cream for the face or the front of the neck is not available?

Yes

No

Do you have a history of using Fucibet cream to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Has the target user tried a different medicine to address the symptoms before?
If yes, what medicine was consumed and how effective was it?

Yes

No

For how long has the person who will use this medication experienced these symptoms?
Please select your option

At least 72 hours

A week

A month

More than a month

What symptoms do you intend to treat using this medicine?
Please provide more information

Did you know that betamethasone cream for the face or the front of the neck is not available?

Yes

No

Do you have a history of using betamethasone (Betnovate) cream/ointment to treat the same problem?
If you do, when was this and how successful was it?

Yes

No

Do you moisturize your skin frequently particularly the body parts that are prone to dryness and/or crackin)?
If you do, please tell us about any other lotions or ointments you currently use or have used.
Did you know that you should use an emollient cream or ointment to frequently moisturise spots of eczema or dermatitis (up to four times daily)?
Do you require assistance?

Yes

No

Did you know that:
A healthcare practitioner should assess any acute injuries.
You should see your doctor about chronic pain at least once a year.

Yes

No

Do you have a nut allergy particularly to coconut?
Coconut oil can be found in Betacap.

Yes

No

Are you aware that Betacap Scalp Application can cause a fire when handled without caution?
After using Betnovate Scalp, do not use a hair dryer or smoke.

Yes

No

Do you have a history of using Betacap Scalp Application to treat the same problem?
If you do, how successful was it?

Yes

No

Did you know that that new rashes, worsening rashes, and rashes that don't respond to treatment require urgent medical attention?
Do you require assistance?

Yes

No

For which duration have you suffered from scalp condition
Kindly select your option

It's the very first time

It's been a year and a half

Between one and five years

Five years or more

Do you intend to use this lotion only on dry, itchy, flaky, or irritated scalp skin?
If not, please explain where you intend to use the product

Yes

No

Do you mind sharing an image of your scalp condition.
A photograph will assist our healthcare team in making an informed decision about your treatment and will allow us to provide you with any additional information that may be required.
This question is not mandatory

Only .jpg, .jpeg, .png, and .gif formats are allowed.

Is there any difference in the occurrence of your ailment now compared to when it was first diagnosed?
If there is, kindly describe the changes

Yes

No

Have you seen a doctor about your scalp problem?
If you havent, what gives you the assurance that this treatment is suita ble for you?

Yes

No

Can you relate to any of the following statements?
You have or have had stomach or duodenal ulcers, as well as stomach or intestinal bleeding in the past.
Your doctor has ever told you that your kidney function is less than 100 percent.
You have previously suffered a terrible reaction to aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs).
You want to use Ibuprofen Gel on skin that is fractured, injured, diseased, or infected.

Yes

No

What is your biological gender?
Please select your option

Male

Female

Transmale (Born a female)

Transfemale (Born a male)

If female or transmale, are you currently pregnant, breastfeeding or planning to do so?
Please select your option

Presently Pregnant

Presently Breastfeeding

Planning on getting pregnant

Neither Pregnant nor Breastfeeding

Do you have a history of using other ointments or lotions to manage your condition?
If so, please describe them and whether or not they were successful.
Do you require assistance?

Yes

No

For which duration have you been experiencing eczema/dermatitis
Kindly select your option

Just this once

About 18 months

Around two to five years

Five years or more

Our team strongly advise you to include a photo of your skin issue.
This will help you avoid delays in receiving your order, especially if:
You have not tried any other steroid or moisturising creams before buying a topical antibiotic like FUCIDIN, FUCIDIN H, or FUCIBET.
have not had the ailment confirmed, do not moisturize the affected area on a daily basis, and are wanting this for a reason other than eczema
A photo will aid our medical team in making the best treatment option possible. The photo should be taken up close. It is not necessary to illustrate the entire region.
This question is not mandatory

Only .jpg, .jpeg, .png, and .gif formats are allowed.

Kindly describe which specific parts of your body require this product's treatment?
kindly provide the specific details describing the exact area, including and how it looks.

Is there any difference in the incidence of eczema/dermatitis now compared to when it was first diagnosed?
Do you require assistance?

Yes

No

Have you seen a doctor about your eczema/dermatitis?
Do you require assistance?

Yes

No

Do you have a flare-up of your eczema or dermatitis right now?
Do you require assistance?

Yes

No

Can we share this information with your General practitioner?
Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advice you share this treatment with your doctor for him/her to update your medical records.

Yes

No

Can you relate to any of the following?
You have an underlying medical condition
You've been through a major surgical procedure
You have allergic reactions
You have cardiovascular conditions or might have had suffered a stroke
You suffer from a low liver or kidney function

Yes

No

Are you currently receiving any treatment or using any medication?

Please provide more information of the medication being used if any.

Yes

No

Do you have a bad case of dandruff on your head right now?

Yes

No

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