Facial Hair Removal For Women consultation

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indicates a mandatory field that must be completed

I confirm that I am suffering from excess facial hair.

Yes

This question is required and must be answered.

I understand Vaniqa is for long-term use and may take up to 4 months to work.

Yes, I confirm

This question is required and must be answered.

I understand Vaniqa slows down hair growth, but Vaniqa is not a hair-remover.

Yes, I confirm

This question is required and must be answered.

I understand Vaniqa is used only on the face and under the chin and is NOT likely to work on other parts of the body.

Yes, I confirm

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 take any medication, or have any medical conditions?

Yes

This question is required and must be answered.

Do you have any disabilities or special needs that we should be aware of, in order to provide you with the best possible care?

For Example: ADHD, ASD or Learning Difficulties. 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.

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.
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 Facial Hair Removal For Women

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