Eczema Treatment

Do you suffer from Eczema?

Would you like to try a new investigational treatment for Atopic Dermatitis or Eczema at no cost to you?

Sign up and we will notify you of clinical research trials in your area that need volunteers with Atopic Dermatitis.

Volunteers who take part in the trial may be compensated for trial-related travel.

No health insurance is required to participate. All trial-related visits, tests, and investigational treatment will be provided at no cost. In addition, compensation for trial-related travel may be provided. The trial will involve visits to a trial site in your area.

What happens if I sign up?

You may be eligible for an Atopic Dermatitis clinical research trial, also known as a clinical trial in your area. Someone from the trial team or research site conducting the trial will contact you to explain more about this research trial before you make your decision about participating.

Sign Up

Fields marked with an * are required.

First Name *

Last Name *

Primary Phone Number (please provide a cell phone number if possible) *

Is this a cell phone? *

Secondary Phone Number (if applicable)

Date of Birth MM/DD/YYYY *

ZIP or Postal Code *

Have you been diagnosed with Atopic Dermatitis/Eczema? *

When was your Atopic Dermatitis/Eczema diagnosed? *

What percentage of your skin surface is covered with Atopic Dermatitis/Eczema? *
Note that 1% is approximately the size of your palm.

Do you currently have any Atopic Dermatitis/Eczema lesions on your scalp? *

Please list any current medications you are currently taking for your Atopic Dermatitis/Eczema below. *
If you are not taking any medications for your Atopic Dermatitis/Eczema please write ‘none’.

Have you taken any of the following medications to treat your Atopic Dermatitis/Eczema within the past 6 months? *

Have you been told by a doctor that you currently have any of the following skin conditions? *
Please select all that apply. Please hold down CTRL to select more than one.

Do you have any other major health conditions? *
Please list them below, or type ‘none’.

Have you had any major surgery in the past 2 months, or are you planning to undergo in-patient surgery within the next 5 months? *

If female, are you currently pregnant, breastfeeding or planning to become pregnant in the next 5 months?

Are you currently enrolled or have you participated in a clinical trial within the last 30 days? *

Would you like to be contacted about taking part in a clinical trial? *

What is the best day/time to reach you via telephone (we know you are busy)? *
Please note that most of our Trial site/research centers are open Monday to Friday 8am – 5pm. If possible, please provide availability in this time window. Our Trial sites will do their best to accommodate your request, however they may not be able to reach out outside of their business hours.

The information you are providing here will only be used to match you or a friend or family member to a clinical research trial in the potential participant’s area and contact you to see if you would like to participate. Please note the information you enter will be kept private, except when ordered by law, and only accessible to our Clinical Research Partners and affiliates and applicable regulatory agencies. If you have any questions regarding the handling of the information you have provided to autocruitment.com, or if you would like to make any changes, please contact us at info@autocruitment.com.