| How many days have you been experiencing these symptoms? |
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| I confirm that all the information I have provided is accurate. In addition, I will only take any treatment prescribed according to the prescriber\’s prescription instructions and notify my own GP of any treatment I am prescribed from My Chemist Plus Pharmacy. |
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| Are you currently taking any other medications? |
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| Who is the medicine for? |
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| What are the symptoms? |
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| How many days have you been experiencing these symptoms? |
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| Have you tried any other treatment for this condition? |
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| Are you taking any other medication which may have been prescribed,bought over the counter. Including herbal and homeopathic remedies. |
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