If this is not for yourself, please can you tell us who it is for and their age. e.g. grandmother (79yrs old)

Use the calendar to select your date of birth. 

Your height is important for the prescribers decision.

Please make sure to add your current weight. This may affect the prescriber's decision.

Days, weeks, months or years

If so, please provide more information.

This could be prescription medication, over the counter or herbal remedies.