Psoriasis Consultation Form

    Have you been diagnosed with psoriasis by a GP or dermatologist?

    YesNo

    We would strongly recommend getting a formal diagnosis prior to ordering treatment- You can book an appointment with one of our clinicians by clicking here

    Please list your current symptoms (eg skin dryness, redness, itchiness, etc).

    Please state which areas of your body are affected by psoriasis?

    Are you currently pregnant or planning a pregnancy?

    YesNo

    Apologies but we are unable to recommend this product for you. If you have any queries please contact support@digiderm.co.uk

    Are you currently breastfeeding?

    YesNo

    Apologies but we are unable to recommend this product for you. If you have any queries please contact
    support@digiderm.co.uk

    Are you currently using any medications to treat your psoriasis?

    YesNo

    Please list any medications you are currently using, including over the counter or prescription only and if they are effective. Please also include any information on medications you have tried in the past and whether or not they were effective


    Now Please take 3 photos of your skin and attach them below:


    If taking pictures of your face make sure you take off your glasses, keep your hair out of your face and remove any make up if you are wearing any.


    Find a good light. You can do this by standing in front of a window.


    Turn off any filters on your device so we can see the real you.


    Make sure your skin problem fills the screen so we can zoom in as needed. Don’t hold your device too far away from your skin as it will be harder to see.


    All pictures uploaded are 100% confidential and will only be looked at by the clinician involved.


    Click on the camera icon below to upload photos. Please take three photos and try to vary the angles take one looking straight at the skin issue and the other two viewing it from either side.


    Choose Your Front Facing Photos. (We accept JPEG, JPG, PNG, Max 5MB Per Photo)


    Choose Your Left Facing Photos. (We accept JPEG, JPG, PNG, Max 5MB Per Photo)


    Choose Your Right Facing Photos. (We accept JPEG, JPG, PNG, Max 5MB Per Photo)

    Do you agree with the following?

      li>You are aware that if you develop any new, worsening or treatment-resistant rashes you should see your GP. li>You are aware that paraffin containing products can cause a fire hazard. li>You are aware that steroid creams should be applied thinly and for short term use because they can otherwise cause skin damage, and that when treating eczema and psoriasis you should always use regular emollients alongside steroids as the main form of long-term treatment.

    • You agree with our terms and conditions and privacy policy, you are at least 16 years old and currently resident in the UK. (Terms & Conditions | Privacy Policy)

    • Please list any treatments you have previously tried and whether they have been effective or not. Please also tell us about any previous side effects or reactions to previous treatments.

    • This treatment is to be used only by you.

    • The answers provided to the above questions are true and accurate.

    YesNo