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0%


Male
Female
Transmale (Born a female)
Transfemale (Born a male)




0%



Face
Chest
Back
Arms
Other

Less than 1 month
Between 1 month and 3 months
More than 3 months

Inflamed spots
Whiteheads
Blackheads
Tender lumps under the skin



Presently Pregnant
Presently Breastfeeding
Planning on getting pregnant
Neither Pregnant nor Breastfeeding



If so, please provide more information



0%



- I am between the ages of 18 and 65 - This treatment is for my use only - I have the capacity to make decisions about my own healthcare - I have understood all the questions and have answered this consultation truthfully and completely - I understand the prescriber will use my answers and base their prescribing decisions accordingly, and that providing incorrect information could be harmful to my health - I will read the patient information leaflet supplied with this medication - I will contact we prescribe and inform my GP if I experience any side effects from this treatment or if there are any changes to my health - I have read, understood and agree with our Terms and Conditions