{chronoforms}eczema_treatment_plan{/chronoforms}

Patient name and address

Patient UR

Treatment Plan Acute or Maintenance

* Soaking off crust prior to medicated creams/ointments
Yes No
Medicated cream/ointment
Face

Until clear
Frequency
MorningNoonAfternoonNightTwice weekly
Body

Until Clear
Frequency
MorningAfternoonNoonNightTwice weekly
Wet Dressings
Face
Cool compress
Arms
MorningNoonAfternoonNight
Legs
MorningNoonAfternoonNight
Body
MorningNoonAfternoonNight
Please note in comments field if you are using T-shirt, Singlet, or Tubifast
Scalp and Neck:
BandanaNeck scark
Only to be used when awake
Wet dressings on top of the following
CortisoneMoisturiser
Medications

Frequency
Morning NoonAfternoonNightWeekly
UV Therapy
Yes No
Additional Instructions
White King BleachSaltBath oil
Everyday Preventative Care
Bathing

Moisturising

Face and body
Frequency
MorningNoonAfternoonNight
Additional Information

This plan was written by:

Date

*Security Check

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