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0%


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




0%


Less than 3 months ago
Between 3 months and 6 months ago
Between 6 months and 1 year ago
Over a year ago


  • Any unexplained spots or lesions
  • Any flaking
  • Any swelling
  • Any pain or inflammation




This can include:

  • Immune system conditions such as HIV
  • Liver or kidney issues






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