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Hair Loss 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 a male and over the age of 18?

Yes No

Are you suffering from male pattern baldness (hair loss)?

Yes No

Do you have a known allergy or hypersensitivity to finasteride or minoxidil?

Yes No

Can your hair loss be attributed to the use of other medication or illness?

Yes No

Is your hair loss sudden or have you experienced complete hair loss?

Yes No

Are you suffering from an inflamed or itchy scalp, or is your hair loss irregular and patchy?

Yes No

Medical Conditions

Do you suffer from any of these conditions:

Male breast cancer
Chronic liver disease
Prostate problems including enlarged prostate or cancer
Severe bladder issues
Any heart related conditions such as high blood pressure, heart disease, angina, etc

Yes No

Have you ever been diagnosed with depression or suicidal thoughts?

Yes No

Medication

Are you already taking finasteride or other similar medications such as dutasteride?

Yes No

Agreement

Do you understand that:

Whilst taking Finasteride, if your partner is or may be pregnant, they should not touch crushed or broken Finasteride tablets, and a condom should be worn during sexual intercourse
In rare cases Finasteride can cause sexual dysfunction such as erectile dysfunction, low sex drive and ejaculation issues. These may persist after stopping treatment.
You should stop finasteride and contact your GP if you experience any of these symptoms:
- Depression or suicidal thoughts
- Erectile dysfunction
- Reduced libido
- Any changes in breast tissue such as enlargement, lumps or nipple discharge
It can take 3-6 months of continuous once-a-day usage of hair loss medication to see any improvement
You should inform your GP that you are taking finasteride before undergoing a PSA (prostate-specific antigen) blood test for your prostate as this can affect results

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

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

Quantity:

£76.99

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