NPF Patient Navigation Center Participant Intake Questionnaire

Thank you for contacting the National Psoriasis Foundation Patient Navigation Center (PNC) and providing your input on living with psoriatic disease.

Using the data you provide, your Patient Navigator will be able to:
  • Better understand your current status of psoriatic disease
  • Provide you with information to help you on your journey towards a healthier life
Your de-identified data contributes to a better understanding of how psoriatic disease impacts lives. It also provides information for NPF to better advocate for those living with psoriatic disease.

Please answer the following questions about your psoriatic disease. Your responses will be kept confidential.

Demographics




MM/DD/YYYY
















Psoriatic Disease




Comorbidities



Insurance



Health Care Provider







Treatment









11. How much do you agree or disagree with the following statements?




Goals




Patient Navigation Center (PNC)







Stay in the Know

Expert tips, can’t-miss events, and the latest news, straight to your inbox.

National Health Council Standards of ExcellenceCharity NavigatorCommunity Health Charities logo

Copyright © 1996-2023 National Psoriasis Foundation/USA


Duplication, rebroadcast, republication, or other use of content appearing on this website is prohibited without written permission of the National Psoriasis Foundation (NPF).


NPF does not endorse or accept any responsibility for the content of external websites.


NPF does not endorse any specific treatments or medications for psoriasis and psoriatic arthritis.

We use cookies to offer you a better experience and analyze our site traffic. By continuing to use this website, you consent to the use of cookies in accordance with our Privacy Policy.