Pharmacy medicines are sold at the professional discretion of our pharmacist. Please answer the following questions accurately to allow our pharmacist to check that this product is suitable for the intended user(s). All information provided will be treated confidentially and will only be available to pharmacy staff processing your order.
Important: Our pharmacists only have access to the details you provide in this form. They don't have access to patient information provided online on previous occasions. If your previous responses are shown below, please check that your answers are still correct.
GPhC Registered Premises: 1103628 * Answer Required