This form is to be completed by a health care professional caring for a patient with psoriasis and COVID-19.

This form should be completed after the patient has had COVID-19 for a long enough duration to experience partial or complete recovery, hospitalization or death.

It is not the project’s intention to collect or process any personal data so please do not volunteer any information which could be used to identify a living individual. Any such information will be permanently deleted prior to data analysis.

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