- Frequently Asked Questions

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Why join Psoriasis Support Canada?

* Please note, answers to all questions required.

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First Name, Last Name:

Gender:

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Language:

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E-Mail address:

Postal Code:

Age range:

	18 and under
	19 - 25
	26 - 35
	36 - 45
	46 - 59
	60 +

Would you consider your psoriasis to be:

	Mild
	Moderate
	Severe
	Very Severe

Please take a moment to answer the following:

	I have been diagnosed with psoriasis
	I think I may have psoriasis
	I have a rash on my skin, but don’t know if it’s psoriasis
	I am a dermatologist
	I am a family physician
	I am a nurse
	I am a pharmacist
	I am an alternative health provider
	I am a psychologist or social worker
	I am an employer or colleague of someone diagnosed with psoriasis
	I am a family member or friend of someone diagnosed with psoriasis
	Other, please specify:

How did you hear about Psoriasis Support Canada? (Click the one that applies most)

	Internet search i.e. Google, Yahoo, etc.
	Newspaper or magazine article
	Television
	Radio
	Dermatologist
	Family physician
	Psoriasis or phototherapy clinic
	Consumer/trade show or information session
	Friend/relative
	Psoriasis Support Canada brochure
	Other

Consent and Privacy

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Join Psoriasis Support Canada

I would like to become part of the PSC community!

Yes, I would like to join the PSC community! I give permission to PSC to add my name to the membership list so that I may receive information updates and news about psoriasis.

Continuing education in the area of Psoriasis

Yes, I give permission for information on this form to be provided to Astellas Pharma Canada, Inc. to help respond to patient needs and assist with changes and improvements to PSC education initiatives.

If, at any time, you would like to stop receiving information, please contact us at info@psoriasissupport.ca. PSC will not use or disclose any personal information to third parties without your consent. PSC does not sell, rent or lease its membership lists to third parties.

By submitting this form, you agree to PSC Terms of use and Privacy Policy.

Psoriasis Support Canada has been made possible thanks to an educational grant from Astellas Pharma Canada, Inc., a leader in the field of Dermatology.

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