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Your Vitiligo Story: Tell the World

What is your gender?
At what age did you develop vitiligo?
How many months or years have you had vitiligo?
How do you describe your skin tone?
What kind of vitiligo do you have?
Select any/all activities that have impacted your participation because of vitiligo
Before you developed vitiligo, did you participate in more social activities?
Have you ever felt that if you didn’t have vitiligo your life would have been better?
Have you ever avoided or canceled appointments for:
Select each response below that applies to actions you’ve taken because of vitiligo.
Has your vitiligo ever made you feel sad, discouraged, or depressed?
Managing my vitiligo on a daily basis is a burden?
Do you worry about your vitiligo spreading?
Could vitiligo influence you to NOT have children?
Do you find warm weather more difficult because more of your vitiligo is visible?
Do you feel that your family understands how vitiligo makes you feel?
Do you feel that your friends understand how vitiligo makes you feel?
Have you ever been stared at in public because of vitiligo?
Do you mind when people ask you about vitiligo?
Have you ever seen a doctor about your vitiligo?
Was your vitiligo ever diagnosed INCORRECTLY by a physician?
Have you ever used/tried a vitiligo treatment, product, or supplement that you found online?
If you HAVE used an online vitiligo treatment, product, or supplement, what factors influenced your decision to try an online product?
If you HAVE used an online vitiligo treatment, product, or supplement, did it work for you?
About how many online treatments, products, or supplements have you used since being diagnosed with vitiligo?
If you have used an online vitiligo treatment, product, or supplement, what is the most you’ve spent on these products in a single year?
Have you ever used a vitiligo treatment prescribed by a physician?
If you NEVER tried a treatment, select all reasons that influenced that decision.
If you NEVER tried a treatment, were there ever times you WISHED that you HAD treated your vitiligo?
If you NEVER tried a treatment, but WISHED that you HAD treated your vitiligo, What made you wish that you HAD tried a treatment?
If you DID try treatment/s, did your doctor make you feel encouraged about the treatment/s working?
If you DID try treatment/s, did your doctor explain how long it would take for the treatment to work?
If you DID try treatment/s, did your doctor explain what to expect, or how you could tell if/when the treatment was working?
If you DID try treatments, did insurance cover any part of the treatment cost? Select all that apply.
If your insurance company did NOT cover your treatments, did your physician's office TELL you that you could file an appeal?
If your insurance company did NOT cover your treatments, Did your physician’s office HELP to file an appeal?
At any point in your life was there a treatment/s that you WANTED to try but you were UNABLE to?
If you DID want to try a treatment but were UNABLE to, select all reasons that kept you from trying.
If there was a safe treatment that you could afford, that worked well, and you only had to use it once a week, would you consider trying it?
Is there anything that you want the world to know about vitiligo?
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