Allergic dermatitis Eczema

What is Allergic dermatitis Eczema?

Allergic eczema is a form of eczema that occurs in response to contact with an allergen. An allergen is any substance to which a person may be allergic. It is commonly called contact dermatitis.

The primary symptom of allergic eczema and other eczema types is a dry, itchy rash. Some types of eczema may be painful or cause blisters to form. However, people who have severe reactions may notice the symptoms elsewhere. We can care for you, just answer these few questions to better care for your unique needs.

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Patient Intake Form - Allergic Dermatitis Eczema

First Name

Middle Name

Last Name

Phone no.

Address

City

State

Zip Code

Country

Date of birth

Patient Gender

Weight (Lbs)

Do you have an history of eczema, do any one in your family have Eczema?

Yes

How long have you been having eczema, and what are your current treatments?

When did you first notice the rash?

Do you have any of these symptoms? Blistering, itching, burning, rash, redness, swelling. Please specify in your own words.

Have you recently changed lotion, shower gel, clothe detergents or started any new medications?

Yes

Pharmacy Name

Pharmacy Address

Address

City

State

Zip Code

How did you hear about us?

I have read and agree to GreatDoctorUSA Consent Form.

Payment Details

Price: $29.99

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COMMON QUERIES

FAQs

How does the consultation process work?

Select an applicable condition, answer a few health questions and submit to a licensed to a licensed medical provider for review. If applicable, a phone call, text, or video chat may be needed. Once completed, a prescription will be sent to the pharmacy or delivered to your doorstep.

Can I use my Insurance?

We are not accepting any insurance carriers at this moment. We can provide you with an itemized receipt for insurance reimbursement.

What if my pharmacy does not have my medication?

Contact us immediately via email or text. We’ll be happy to resend your prescription or transfer it to a different pharmacy. Unfortunately, this does not qualify for cancellation or refund.

What if my insurance does not cover my medication?

You may pay out of pocket or request an alternative drug.

Is your service fee refundable?

Yes, prior to us rendering the service. Unfortunately, the consultation fee is nonrefundable once we have rendered the service or ordered the prescription. We’re happy to retreat, reevaluate, or rectify any issues that may arise.