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Disclaimer - Hayfever Consultation Form

Your complete and honest disclosure will enable our healthcare professionals to make informed decisions and provide you with the best possible care. Please provide accurate and detailed information when needed in the consultation questionnaire below.
 

Do you need help completing this questionnaire? Email us or Call us during our working hours (9am - 5pm / Monday - Friday)

Medical Questions

What is your gender?
What is your Date of Birth?
Day
Month
Year

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Healthy eating, reduced alcohol consumption, a healthy body weight and smoking cessation are advisable. Do you understand this?
Acid reflux treatment from this service to treat acid reflux can only be used for a maximum of 28 days. Do you understand this?
If you experience no relief after 14 days or your symptoms persist after 28 days of treatment you must contact your GP for further diagnosis/treatment. Do you understand this?
Would you like us to inform your GP?
10mg
7 Capsules: £1.99
14 Capsules: £3.49
28 Capsules: £7.99
20mg
7 Capsules: £2.49
14 Capsules: £4.49
28 Capsules: £8.49
Product
Omeprazole Capsules
Omeprazole Capsules£1.99
Medicine type
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