About Your Health
To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.
0%
Back
Are you the target user of this medicine?
If not, please describe in detail who the intended consumer is and how old he/she is.
Do you experience any of the following?
You are under medication or receiving supplements
Does any of these describe you?
You have an underlying medical condition
Are you currently receiving any treatment or under any medication?
Please provide more information of the medication being used if any.
If female or transmale, are you currently pregnant, breastfeeding or planning to do so?
Please select your option
Date of Birth
Use the calendar to select your date of birth.
Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Month January February March April May June July August September October November December Year 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924
Are you familiar with the following prevenventative methods that reduce re-infection and spread of the infection
Seek immediate medical assistance once infected
Did you know that you must seek further medical assistance if:
Your infection does not seem to improve after two weeks of using the medicine
Do you know how to how to use Daktarin powder?
Before applying the product, your feet should be thoroughly cleaned and dried especially the toes
Does the following apply?
A weakened immune system
Has the target user tried a different medicine to address the symptoms before?
If yes, what medicine was consumed and how effective was it?
Since when has the intended user experience these symptoms?
Please select your option
Where do you intend to use this product?
It could be on your shoewear, feet etc
What symptoms do you intend to address using this medicine?
Do you know how to how to use Lamisil AT 1% Gel?
Before applying the product, your feet should be thoroughly cleaned and dried
Submit
