Hidradenitis Suppurativa Study Application

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Name *

First

Last

Age *

Email *

Phone Number *

Example: 3175165030

1. How did you find us? *–PhysicianFriend or FamilySocial MediaOffice FlyerOther

2. If you were referred by a staff member, please list name

3. Do you have at least 5 inflammatory HS lesions? *–YesNoUnsure

4. Have you had at least 28-days of antibiotic treatment for your HS? *–YesNoUnsure

5. Have you had at least 3 months of antibiotic treatment for your HS? *–YesNoUnsure

6. Have you previously used the biologic therapy Humira to treat your HS? *–YesNoUnsure

7. Have you previously used the biologic therapy Cosentyx to treat your HS? *–YesNoUnsure

Submit

By submitting your information, you give Dawes Fretzin Clinical Research Group permission to contact you regarding study opportunities.

For additional information on these studies, please visit:
https://clinicaltrials.gov/study/NCT06468228?term=m20-465&rank=1
https://clinicaltrials.gov/study/NCT05889182?term=m23-698&rank=1 https://clinicaltrials.gov/study/NCT06799000?term=clou064j12301&rank=1
https://clinicaltrials.gov/study/NCT07228390?term=b7981119&rank=1