Part 1 of 4
Symptoms & Experience
Please answer these clinical questions as accurately as possible. your answers are 100% confidential and reviewed only by our medical team
Is this consultation for yourself?
Yes
No
Are you aged between 18 and 75 years old?
Yes
No
Which of the following best describes your experience ?
Select the option that most accurately reflects your situation over the past 3 months
Select the option that most accurately reflects your situation over the past 3 months
How long has this been an issue ?
Understanding the timeline helps our clinicians determine the best treatment plan
Understanding the timeline helps our clinicians determine the best treatment plan
Previous Medication Experience
Have you tried any of the following treatments before?
Have you tried any of the following treatments before?
Have you tried ED Treatments before?
Are you currently taking any of these?
Additional Details (Optional)
RECOMMENDED
Please describe your symptoms in more details. including any lifestyle changes or stressful events that might be relevant.
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GPhC REGISTERED
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