The purpose of the Rosacea-Ltd IV Assistance Form for existing Rosacea-Ltd IV patients only:
To assist you in improving the appearance and condition of your rosacea, acne or seborrheic-dermatitis skin condition, please complete all blanks below. Optional information (up to a full page of your comments) is welcome in the comment section.
Please be precise so we can assist you. We need to know what you have been doing, and what you have "NOT" been doing'. You are not limited to the boxes below as they will continue for several paragraphs if needed.
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