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Acne Prescription

Medical Assessment

Answer a few quick and easy questions from our pharmacists to see what treatments you’re eligible for.

Your Health

Are you aged 18 years or over?

Yes No

Your answer changed, Can you share why your response changed?

Do you suffer from mild to moderate acne?

Yes No

Your answer changed, Can you share why your response changed?

Do you have a known allergy or hypersensitivity to any of the following:

Clindamycin/lincomycin

Benzoyl Peroxide

Adapalene

Erythromycin

Zinc

Tretinoin

Azelaic acid

I am not allergic to any of the above

Are you pregnant, planning to become pregnant, or breastfeeding?

Yes No

Your answer changed, Can you share why your response changed?

Medical Conditions

Do you suffer from Inflammatory Bowel Disease such as ulcerative colitis, crohn’s disease, or other forms of colitis?

Yes No

Your answer changed, Can you share why your response changed?

Do you have a personal or family history of skin cancer?

Yes No

Your answer changed, Can you share why your response changed?

Are you suffering from acute eczema, rosacea, or other inflammatory skin conditions?

Yes No

Your answer changed, Can you share why your response changed?

Medication

Are you currently taking any oral antibiotics?

Yes No

Your answer changed, Can you share why your response changed?

Are you taking the following medications:

Anticoagulants such as Warfarin
Corticosteroids
Neuromuscular blocking medicines

Yes No

Your answer changed, Can you share why your response changed?

Agreement

Do you understand that it can take 4-8 weeks of treatment before an improvement is seen and that the topical treatments should be used continuously for a few months to obtain the best results?

Yes No

Do you understand that topical acne treatments can cause your skin to become more sensitive to light (photosensitive)? It is advisable to avoid sunlamps and sunlight whilst using topical acne treatments and to use sunscreen and protective clothing if exposure to sunlight is unavoidable.

Yes No

Do you understand that before any cream is applied, the skin should be cleaned with plain water and dried? A mild skin-cleansing agent can be used.

Yes No

Do you understand that in some cases, skin irritation and redness can occur when first starting treatment? If this occurs, the amount of cream applied should be reduced during application, or the frequency should be reduced. It may be advisable to pause treatment temporarily till irritation has subsided. If the irritation is intolerable or persists, treatment should be discontinued and advice should be sought from your doctor.

Yes No

Do you agree to the following:

You will read the patient information leaflet before using this medication
You are aged 18 years or over
You have answered all questions truthfully and accurately
You understand that we take your answers in good faith and any false or incorrect information given can be hazardous to your health
This treatment is solely for your own use
You will contact us and inform your GP if you experience any side effects with your treatment, you start any new medication/ your medical conditions change during treatment
You will inform your GP of this treatment if this is appropriate

Yes No

GP Details

We can notify your GP of your treatment for you. To do so, we need their contact information. Sharing this information allows your GP to maintain a comprehensive record of your medical history, which is crucial for your health. Without complete records, there could be potential risks to your well-being.

I consent to YourMedicals contacting my GP and share information about my prescription.

Yes No

Practice/GP Name

Practice/GP Address

Verify your BMI

To comply with regulations and ensure the safe provision of weight loss treatment, we need to verify your BMI. You may complete this step later, but we cannot proceed with your prescription until it is provided.

Upload Now Upload Later

Upload Your ID

Please upload a government-issued photo ID that meets the following criteria:

Clearly shows your face, name, and date of birth.
Ensure the image is free from reflections and blurriness.
All four sides of the ID must be visible.

Why We Request a Photo ID

We prioritise your safety and ensure compliance with medical regulations. Our prescribing team requires a government-issued photo ID to:

Verify your identity.
Ensure that all information you have provided matches the details on your ID.

Your information is handled with the utmost confidentiality and security

Upload ID

You have chosen to upload your documents at a later time. A confirmation email will be sent to you shortly with instructions for uploading.

Please note, your order will be placed on hold until the required documents are uploaded. Once the documents are provided, we will proceed with processing your order.

Complete our 2 minute questionnaire

Confidential

Our prescribers will carefully review your information with full confidentiality.
Your medication will be delivered in plain, unmarked packaging
All data is securely encrypted using 128-bit SSL encryption.

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