Malaria consultation | Oxford Online Pharmacy

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indicates a mandatory field that must be completed

Please provide details of all the countries that will be visited during this trip.

How long are you staying in EACH of the countries you are planning to visit?

Please provide details of the trip e.g., backpacking holiday, staying at a resort etc

Please confirm that you understand that Doxycycline capsules can cause side-effects such as upset stomach and severe sensitivity to sun-light even in people with naturally darker skin.
We usually recommend Malarone - Atovaquone / Proguanil tablets for all trips of less than 30 days.

Yes, I confirm

Do you take any medication, or have any medical conditions?

Yes

This question is required and must be answered.

Do you have any information or communication needs because of a disability (for example ADHD, ASD or Learning Difficulties), impairment or sensory loss that we should be aware of, in order to provide you with the best possible care?

This will help our clinicians and pharmacy team to allow you access all our services safely.

Yes

This question is required and must be answered.

Do you have any known allergies? E.g. Penicillin, egg protein or peanuts or an allergy to the ingredients in some medication eg lactose?

Yes

This question is required and must be answered.

Do you have any liver or kidney problems, including reduced kidney function or chronic liver disease?

Yes

This question is required and must be answered.

Are you breastfeeding or pregnant or planning to be pregnant?

Yes

This question is required and must be answered.

Do you give us permission to inform your NHS surgery, about this prescription?

Yes

It is important to tell your doctor of any medication you have been prescribed for them to be able to treat you appropriately, safely and to avoid any drug interactions.

I am over 18 and this is for my sole use. I understand this is a non emergency service. I confirm I have answered all questions accurately and understand the doctor will use this information to prescribe safely for me.

Yes, I confirm

This question is required and must be answered.

By providing us with your details you confirm that you have read, understood and agreed to the legal terms and you consent to the sharing of your data to use our service.

Yes, I confirm

This question is required and must be answered.

By providing us with your details you confirm that you have read, understood and agreed to the legal terms and you consent to the sharing of your data to use our service.
I consent to treatment and an identity check
I give consent for the pharmacist to access and store relevant information from my NHS summary care record which may be needed to safely prescribe.
I agree to read the Patient Information Leaflet supplied with the medication.

Yes, I confirm

This question is required and must be answered.

Online Consultation for Malaria

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