ITSAN CoStEx and WaR Survey (v1)
ITSAN has developed a new index to estimate Cortico-Steroid Exposure (CoStEx). In addition, WaR is a new index to categorize the Withdrawal and Recovery experience. Your answers are confidential and will only be used to help raise awareness and find solutions for those suffering with TSA/W. After you answer each question, click "continue" at the bottom of the page.
Enter a unique name or nickname of the patient. *
This is for reference only. Use whatever name you like (e.g. Kathy842).
What is your date of birth? *
or child's date of birth if you are completing questionnaire for a child.This date will be used for important calculations. If you are concerned about security/privacy, you may submit an APPROXIMATE date of birth.
MM
/
DD
/
YYYY
Have you ever used a topical steroid cream, ointment, oil, shampoo, etc... either prescription or non-prescription? *
This is referring to anti-inflammatory corticosteroids applied to the skin, NOT testosterone or estrogen creams or patches.
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