Complete this form to express your interest
Clinical trials have inclusion and exclusion criteria, so we need to ask a few questions to see if you are eligible.
If you are eligible, we'll get in contact ASAP and provide you with the full details of the study. If not, we can keep you in mind for future studies.
If you prefer, you can just give us a call on 03 9509 6166 or email us at
and ask for more information on our studies.
Please answer these questions so we can assess your eligibility...
Have you been diagnosed with eczema or atopic dermatitis?
If diagnosed, how long ago?
Less than 12 months ago
More than 12 months ago
Have you treated your atopic dermatitis with pharmacy medicine and had an unsatisfactory response after at least 4 weeks treatment?
What treatments are you using now and tried in the past?
Over the counter ointment or cream
Prescription ointment or cream
Your palm area represents around 1% of your body. For example, 2 palm prints of eczema is 2%.
How much of your body is covered by the rash?
Less than 2%
2-9% of your body
10%-29% of your body
30-49% of your body
50% or more
What is your year of birth?
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