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ED 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 male and aged 18 years or over?

Yes No

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

Do you struggle to achieve or maintain an erection?

Yes No

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

Do you have a known allergy or hypersensitivity to sildenafil, tadalafil, vardenafil, avanafil, or any of the excipients in these medications?

Yes No

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

Have you previously used sildenafil (Viagra), tadalafil (Cialis), vardenafil or avanafil (whether branded or generic), for the purpose of treating erectile dysfunction?

Yes No

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

Medical Conditions

Have you been advised against physical activity by your doctor or do you experience breathlessness/chest pain with light activity such as walking briskly for 5 minutes?

Yes No

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

Do you have any medical conditions?

Yes No

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

Do you have any of the following conditions:

Loss of vision in one eye because of non-arteritic anterior ischaemic optic neuropathy (NAION) or inherited eye disease such as retinitis pigmentosa
Liver disease or severe kidney impairment
Bleeding disorders
Stomach, gastric, peptic or duodenal ulcer
Anatomical deformation of the penis (such as angulation, cavernosal fibrosis or peyronie disease)
Priapism or conditions that can cause priapism such as sickle cell anaemia, multiple myeloma or leukaemia
Cardiovascular disorders including angina, heart failure, arrhythmias, hypotension (low blood pressure), uncontrolled hypertension, cardiomyopathy, valvular heart disease, or blood flow problems due to the heart
Experienced stroke and/or myocardial infarction in the last 6 months
Galactose intolerance, fructose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption

Yes No

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

Medication

Do you take any other medication?

Yes No

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

Do you take any of the following medications:

Nitrates such as isosorbide mononitrate, isosorbide dinitrate and glyceryl nitrate
Nicorandil
Drugs called poppers for recreational purposes such as amyl nitrate
Riociguat
Anti-viral medicaiton such as atazanavir, etravirine, fosamprenavir, indinavir, nelfinavir, ritonavir, saquinavir
Anti-fungal medication such as ketoconazole, itraconazole
Erythromycin/clarithromycin
Rifampicin
Alpha-1 blockers such as doxazosin, tamsulosin
Antiarrhythmics such as quinidine, procainamide, amiodarone and sotalol
Medicines used to treat hypertension (high blood pressure) and heart failure, including diltiazem, sacubitril and valsartan
Cimetidine
Anticonvulsants (Medicines for epilepsy) such as phenobarbital, phenytoin, carbamazepine
Warfarin
Theophylline
Any other medications for erectile dysfunction

Yes No

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

Agreement

Are you aware smoking and drinking alcohol can contribute to symptoms of erectile dysfunction? If you regularly smoke or drink, it may be worth quitting or cutting down to see if your condition improves

Yes No

Do you understand that you should always seek urgent medical help if your erection lasts for longer than 4 hours?

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
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

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.