Consultation - Pharmaceutra

1 About Your Health

Your health and safety are our top priorities. To ensure we provide you with the most effective and appropriate treatment, it is crucial that you provide accurate and complete information about your health during our online consultation process. Accurate information helps us understand your condition better, assess any potential risks, and recommend the best possible medication for your needs. Providing false or incomplete information can lead to inappropriate treatment, potential health risks, and delays in receiving the care you need. Thank you for your cooperation and trust in our services.

Question 1:What is your date of birth?

Question 2:What is your gender?

Female

Male

Question 3:Do you have any known allergies?

Question 4:Do you have any chronic conditions? (e.g., diabetes, hypertension, asthma, etc.)

If yes, please detail them here, otherwise please type N/A

Question 5:Are you currently taking any medications?

If yes, please detail them here, otherwise please type N/A

Question 6:Have you had any surgeries in the past year?

If yes, please detail them here, otherwise please type N/A

Question 7:Do you smoke?

Question 8:Do you consume alcohol?

If yes, how much a day/weekly?

Question 9:What is your typical diet like? (e.g., balanced, high-fat, spicy foods)

Question 10:How often do you exercise? (e.g., daily, weekly, rarely, never)

3 The Agreement and Consent

Please read the Agreement and Consent statements carefully during your consultation. They contain important information to help you stay informed and safe throughout your treatment.

Question 1:Understanding of Risks

Yes

Question 2:Medical Guidance

Yes

Question 3:Consent to Share Information

Yes

Question 4:Confirmation

Yes

Acne

Contraception

Eczema

Erectile Dysfunction

Hair Loss

HRT

Malaria Prevention

Premature Ejaculation

UTI

Weight Loss

Assessment for Acne

Acne

1 About Your Health

Question 1:What is your date of birth?

Question 2:What is your gender?

Question 3:Do you have any known allergies?

Yes

Question 4:Do you have any chronic conditions? (e.g., diabetes, hypertension, asthma, etc.)

Yes

Question 5:Are you currently taking any medications?

Yes

Question 6:Have you had any surgeries in the past year?

Yes

Question 7:Do you smoke?

Yes

Question 8:Do you consume alcohol?

Yes

Question 9:What is your typical diet like? (e.g., balanced, high-fat, spicy foods)

Yes

Question 10:How often do you exercise? (e.g., daily, weekly, rarely, never)

Yes

2 About Your Condition

Question 1:How long have you been experiencing acne?

Question 2:Have you consulted a healthcare provider about your acne?

Yes

Question 3:What type of acne do you have? (e.g., blackheads, whiteheads, papules, pustules, nodules, cysts)

Question 4:How often do you experience acne breakouts? (e.g., daily, weekly, occasionally)

Question 5:Are there specific triggers that worsen your acne? (e.g., certain foods, stress, hormonal changes)

Yes

Question 6:Have you been prescribed medication for acne before?

Yes

Question 7:Are you currently taking any medication for acne?

Yes

Question 8:Have you experienced any side effects from your current or past acne medications?

Yes

Question 9:Have you tried any non-medication treatments for acne? (e.g., topical treatments, lifestyle changes, dietary modifications)

Yes

Question 10:Have you used over-the-counter acne treatments?

Yes

3 The Agreement and Consent

Question 1:Understanding of Risks

Question 2:Medical Guidance

Question 3:Consent to Share Information

Question 4:Confirmation

Assessment Progress

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