Information for Physicians

Physician Materials Request Form

Name:
Specialty:
Institution:
Address:

City:
State:
Zip Code:
Telephone:
FAX:
E-mail:

Please select the materials and note the amounts you would like to receive by mail. Although single copies are available free of charge, for bulk quantities we request a tax-deductible donation of $5 per bulk pack of 25, made payable to the National Rosacea Society.

Patient Education Materials
	Supplied in standard bulk packs of 25 ($5 per pack requested donation). Single copies are available at no charge.
	Understanding Rosacea, an introductory booklet.
	Managing Rosacea, a patient guide for controlling this disorder.
	Coping with Rosacea, a booklet with tips on lifestyle mangagement.
	Rosacea Diary, a diary booklet to help patients find and avoid their personal rosacea triggers.
	Rosacea Triggers, a chart of common rosacea triggers.
	*Rosacea Review*, a patient newsletter.


Professional Materials
	Rosacea Clinical Scorecard, clinical assessment forms (1 tear-tablet of 50).
	Patient Request Cards, allowing patients to order free educational materials from the NRS (1 tear-tablet of 50).
	Office Placard, featuring the standard subtypes of rosacea, including a tear-tablet of patient request cards.
	Faces of Rosacea office poster, with patient photos illustrating the standard classification system.

Article Reprints
	The following items are available as single copies only:
	Wilkin, J et al. Standard grading system for rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. Journal of the American Academy of Dermatology. 2004;50(6):907-912.
	Wilkin, J et al. Standard classification of rosacea: Report of the National Rosacea Society Expert Committee on the Classification and Staging of Rosacea. Journal of the American Academy of Dermatology. 2002;46(4):584-587.
	Blount, BW and Pelltier, A. Rosacea: A common, yet commonly overlooked condition. American Family Physician. 2002;66(3):435-440.
	Lindow, KB and Warren, C. Understanding Rosacea: A guide to facilitating care. American Journal of Nursing. 2001;101(10):44-51.
	Litt, JZ. Recognizing rosacea. The Female Patient. 2000;25:50-58.
	Bikowski, J. Rosacea: The great imitator. Family Practice Recertification. 1997;19:61-65,70-76,81.
	Thiboutot, DM. Acne rosacea. American Family Physician. 1994;50(8):1691-1697,1701-1702.

	Information on specific aspects of rosacea. List below.