Ask Your Doctor Tool

Question 1:

Which condition have you been diagnosed with?

Question 2:

What are your symptoms?

  • List any additional symptoms here.

Question 2:

What are your symptoms?

  • List any additional symptoms here.

Question 2:

What are your symptoms?

  • List any additional symptoms here.

Question 3:

Given your current symptoms, are you able to complete the daily activities that you enjoy:

  • List the activities (if any) that you have difficulty completing/enjoying here.

Question 4:

Which treatment(s) are you receiving for your condition or have received in the past?

  • Write any additional notes about your treatment history here.

Question 5:

How satisfied are you with your current treatment on a scale of 1–5?

  • Write any additional notes about your current treatment here.

Question 6:

My questions today are:

  • Based on this information, what are my treatment options for my condition?
  • What do I need to do to make the switch to a new treatment?
  • What can I expect from my possible new treatment(s)?
  • Who can I talk to about co-pay or other support programs for possible new treatments?
  • Write any additional questions you may have here.

Now that you’ve completed your personalized discussion guide, click one of the links below to explore this site and get more information about XEOMIN:

Learn about the XEOMIN purification process

Read about the financial assistance available for XEOMIN