Assessment | Pharmacy Direct GB

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Complete assessment form

To help us understand that this treatment is the right option for you, please answer the following questions.

Do you agree to the following?

- You declare that I have answered the above truthfully
- You will read the patient information leaflet before taking your medication (if prescribed)
- You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment
- You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health
- You understand that this questionnaire is part of a request to the doctor and the final decision will rest with the doctor

Yes

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Complete assessment form

Complete assessment form