PIO:  Online-Treatment for those affected by Hyperhidrosis
This questionnaire is part of our online coaching and treatment program to maximize your treatment potential against excessive sweating.  The aim of the program is to achieve your personal optimum systematicaly, quickly and safely.  
If you are determined to do something about your excessive sweating - yo've come to the right place/or: this is the perfect thing for you!!!

  • You will write an online "results (impact) - diary" which we can use to thoroughly assess your situation.  
  • We take into account all treatment options that are available against hyperhidrosis based on the current position of medical research.  
  • We are in constant communication until you have achieved your optimum.  Experience has
  •  shown that this may take some time.  That is the reason as to why PIO can only be booked every two months.  
  • PIO is out of pocket expense, i.e. statutory health insurance companies do not cover the costs.  You will be charged € 186,36 / 2 months.  
You incur charges if you tick "Yes - book with payment" at the end of this questionnaire and from the day on which we specifically confirm your admission by e-mail.  

This form is GDPR compliant (german DSGVO). Further information can be found under data protection declaration. Only the DHHZ team can see all information. A Google login is not required. If you log in with your Google account (which is not necessary), Google will temporarily store your data as usual (possibly also outside the EU, depending on your settings).
Sign in to Google to save your progress. Learn more
Email *
I give the DHHZ permission to communicate unencrypted by email with the above-mentioned email address and to store the data from this and other questionnaires that I send as part of the PIO program and the data that I enter in my impact diary. *
Required
Your cell phone number becomes your “customer number”. Please enter your phone number.
 *
Gender *
Date Of Birth *
Height? *
Weight? *
Surname, Name and Address *
List of medications and supplements for your hyperhidrosis are you currently using or you already used? *
in use
used it
I have not used it
Aluminium chloride
Axhidrox
Dysurgal
Iontophoresis
Oxybutynin
Sormodren
Tinktura Bel
Vagantin
Else
What treatments have you already had for your hyperhidrosis?
“EVERYTHING ELSE”: Name other medications and measures that you use or have used to against your hyperhidrosis.
How severe is your sweating if and when you don't do anything about it. 
not at all
some
moderate
very
Head
Armpits
Body
Backside, intimate area
Hands
Feet
Clear selection
How strong are your current hyperhidrosis symptoms, i.e. taking your medications and measures into account. *
not at all
some
moderate
very
Head
Armpits
Body
Backside, Intimate area
Hands
Feet
Are there any other complaints or illnesses that require treatment? If so, mention them here. If not, please write “none.” *
Are you currently on any medication for other complaints or illnesses? If yes, which? If not, write “none”. *
If you suspect a connection between the effects/side effects of your hyperhidrosis measures and other illnesses (or your measures against other illnesses), please write them down here.
Are you pregnant, planning a pregnancy or breastfeeding? (If you tick "yes" here, we cannot treat you now. Just cancel your registration.) *
If you have allergies, mention them here. If not, write "none". *
Please check all that apply 
How high is your OVERALL SATISFACTION with measures you've taken against hyperhidrosis? How many “satisfaction points” do you give? *
Not satisfied at all
Satisfied
What is your current motivation level? *
For some illnesses we need an explicit “yes/no” statement. Do you suffer from any of the following illnesses?
 *
yes
no
Glaucoma (intraocular pressure, damage to the optic nerv)
Anemia
Ulcerative colitis (inflammatory bowel disease)
Myasthenia gravis (MG)
Sjögren's syndrome
Difficulty urinating
Gastric reflux
Heart failure
Cardiac arrhythmia
Impaired kidney function
Hydradenitis suppurativa (HS)
Personal notes
If you have not yet had an initial examination with us, please provide the name of the doctor who diagnosed you with hyperhidrosis, the location and the year of diagnosis. If you haven't been diagnosed, write "none".
 *
Book PIO program now:
 *
Should you answer YES to this question, you are applying to be accepted into our pre-paid treatment program.  However, be aware this will be only concluded after we confirm your admission by e-mail.  
The treatment contract runs for at least 2 months.  Our experience shows this to be needed for an optimal and stable solution).  As soon as you are satisfied, simply break the contract by email to: pio@dhhz.de
If you fail to cancel, the contract will be extended for another 2 months period.  You can always cancel up to the last day before a new 2-month period begins.
PIO is out of pocket expense, i.e. you have to cover the costs of €186,36 for 2 months yourself.  
Would you like to book now and proceed with the payment?  

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