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Asthma Prescription

Asthma Assessment

The following questions are the Asthma Control Test (ACT) and they will help us work out whether your asthma is currently well-controlled.

During the past 4 weeks, how much of the time has your asthma kept you from getting as much done at work, college or home?

All of the time Most of the time Some of the time A little of the time None of the time

During the past 4 weeks, how often have you had shortness of breath?

More than once a day Once a day 3 to 6 times a week Once or twice a week Not at all

During the past 4 weeks, how often have your asthma symptoms (wheezing, coughing, shortness of breath, chest tightness or pain) woken you up at night or earlier than usual in the morning?

4 or more nights a week 2 or 3 nights a week Once a week Once or twice Not at all

During the past 4 weeks, how often have you used your rescue inhaler or nebuliser medication (such as salbutamol/albuterol)?

3 or more times per day 1 or 2 times per day 2 or 3 times per week Once a week or less Not at all

How would you rate your asthma control during the past 4 weeks?

Not controlled at all Poorly controlled Somewhat controlled Well controlled Completely controlled

Your Asthma Control Test Score: 0 / 25

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?

Have you been diagnosed with asthma by your GP or healthcare clinician?

Yes No

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

Has your asthma been reviewed by a doctor or nurse in the last 12 months and have you been prescribed a salbutamol inhaler in that time?

Yes No

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

Do you have a known allergy or hypersensitivity to salbutamol inhalers or their excipients, or have you had any serious side effects with usage of salbutamol inhalers previously?

Yes No

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

Are you comfortable with how and when to use your inhaler?

Yes No

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

Are you having to use your reliever inhaler more than four times a day currently?

Yes No

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

Have you been hospitalised/ had to call an ambulance, or received emergency medical treatment due to breathing difficulties/asthma in the last year?

Yes No

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

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 have any of the following conditions:

Hypertension (High blood pressure)
Any other heart problems such as angina, irregular or fast heart beat
Overactive thyroid gland

Yes No

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

Medication

Do you take any of these medications:

Beta blockers such as bisoprolol and atenolol
Steroid tablets
Xanthine derivatives such as theophylline
Digoxin
Diuretics
Any medications for irregular or fast heartbeat (propranolol, amiodarone, etc)

Yes No

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

Agreement

Do you understand that you should seek medical advice if:

Your inhaler fails to provide relief within one hour of using it
Your bronchodilator inhaler becomes less effective in treating your asthma
You are requiring more inhalations than usual

Yes No

Do you understand that you should seek urgent medical attention if you experience an asthma attack or if you need more than 8 puffs in a 24-hour period? Symptoms of an asthma attack include difficulty breathing, wheezing, coughing, and chest tightness.

Yes No

Do you agree to the following:

You will read the patient information leaflet before using this medication
You will have an annual asthma review with your GP
You are aged 18 years or over
You have answered all questions truthfully and accurately
If you have an NHS Summary Care digital record, our specialists can check it to ensure this medication is safe for you
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 inform your GP that you have been prescribed this medication if this is appropriate
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 are capable of making your own decision about your healthcare and have the capacity to do so

Yes No

GP Details

In compliance with regulations, we must notify your GP about this treatment. 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.

Need help?

If you require assistance with this medical assessment, please reach out to our support team:: 0116 507 0486

Your Asthma Treatments

Salamol 100mcg CFC-free inhaler (200 dose)

Salamol 100mcg CFC-free inhaler (200 dose)

Quantity:

Price: £13.99

Salamol 100mcg Easi-Breathe Inhaler (200 dose)

Salamol 100mcg Easi-Breathe Inhaler (200 dose)

Quantity:

Price: £19.99

Ventolin Evohaler 100mcg (200 Dose)

Ventolin Evohaler 100mcg (200 Dose)

Quantity:

Price: £13.99

Ventolin Accuhaler 60mcg (200 dose)

Ventolin Accuhaler 60mcg (200 dose)

Quantity:

Price: £17.99

Salbutamol Easyhaler 100mcg (200 dose)

Salbutamol Easyhaler 100mcg (200 dose)

Quantity:

Price: £17.99

Airomir Inhaler 100mcg (200 dose)

Airomir Inhaler 100mcg (200 dose)

Quantity:

Price: £14.99

Need Some Extra?

Valupak Multivitamin

£1.99

Valupak Multivitamin

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

£1.99

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

Proceed to Checkout

Need Some Extra?

Valupak Multivitamin

£1.99

Valupak Multivitamin

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

£1.99

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

Proceed to Checkout

Need Some Extra?

Valupak Multivitamin

£1.99

Valupak Multivitamin

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

£1.99

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

Proceed to Checkout

Need Some Extra?

Valupak Multivitamin

£1.99

Valupak Multivitamin

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

£1.99

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

Proceed to Checkout

Need Some Extra?

Valupak Multivitamin

£1.99

Valupak Multivitamin

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

£1.99

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

Proceed to Checkout

Need Some Extra?

Valupak Multivitamin

£1.99

Valupak Multivitamin

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

£1.99

Valupak Vitamin D3 1000IU (25mcg) - 60 Capsules

Proceed to Checkout