Click here to Download the Picking Me Pledge  and upload using the form below.

Contact Information
Are you a Dermatillomania:
If you are a Dermatillomania Sufferer and would like to help us with research, please fill out age & gender in the following fields.
Address Line 1
Postal Code



Please upload a photo of yourself sharing your pledge. We also encourage you to share on social media as well with #PickingMe
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