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Eczema & Dermatitis

Please complete your confidential clinical assessment. Evaluated by GMC & GPhC registered healthcare professionals.

About You & GP Details

General health baseline, age eligibility and GP consent.

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Are you registered with a GP practice in the UK? *

Do you give us consent to inform your GP about this clinical supply? *

Sharing information with your GP ensures continuity of care.

Do you believe you have the mental capacity to make decisions regarding your medical care? *

Are you 18 years of age or older? *

Eczema Flare-Up & Infection Screening

Evaluating severity, infected eczema, and topical steroid safety.

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Do you have dry, itchy, inflamed patches of skin characteristic of atopic eczema or contact dermatitis? *

Does the eczema have yellow weeping crusts, fluid-filled blisters, or sudden painful spreading lesions (suggesting bacterial infection or eczema herpeticum)? *

Medical History & Concurrent Medications

Safety screening for baseline medical conditions and drug interactions.

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Do you have any severe kidney failure, severe liver impairment, or unstable cardiovascular disease? *

Severe organ disease may affect drug clearance and safety.

Are you allergic to any active medications or excipients commonly used for Eczema? *

Including active pharmaceutical ingredients or tablet excipients (e.g. lactose, gelatin).

Are you currently pregnant, planning to become pregnant, or breastfeeding? *

Statutory Patient Declaration

Legal and clinical confirmation before prescriber evaluation.

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Patient Statutory Agreement *

I understand and accept all terms of this Eczema online clinical consultation. *

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