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Maleria Questions

About you

Have you looked on the fitfortravel website (www.fitfortravel.nhs.uk) to ensure malaria pills are recommend in the country you are visiting?


Does the fitfortravel website recommend the specific malaria pills you are requesting for the countries your visiting?


Are you allergic to the following?


atovaquone

proguanil hydrochloride

poloxamer

microcrystalline cellulose

hydroxypropyl cellulose

povidone

 sodium starch glycollate

 magnesium stearate

 hypromellose

titanium dioxide

iron oxide red

macrogol

polyethylene glycol 

Do you or have you suffered from any heart problems stroke, angina or any other heart related problems ?


Are you taking any medication that has been prescribed by your Gp/Doctor or Hospital ?


Do you give consent for us to contact you GP if required? (we need this to process any order for medication)


Your Current Health

Have you ever suffered side effects from taking malaria tablets?


Are you suffering or have you ever suffered from depression, anxiety or panic disorders?


Do you suffer from any problems with your kidneys, your urinary system, your digestive system or your liver?


Are you pregnant or planning to become pregnant or breastfeeding?


Agreements

Are you aware that no malaria tablet will provide 100% protection?


Are you aware that if you get a fever between 1-week and 1-year after return, you should seek medical attention and tell the doctor you were in a malarial zone?


Do you agree to the following statements?


  • You must read the patient information leaflet supplied with your medication
  • You must 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.
  • The treatment is solely for your own use only.
  • You have answered all the questions in this short medical assessment accurately and truthfully to the best of your knowledge. You understand our doctor take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.
all of our tests and treatments are price competative

You need to complete our short medical questionnaire so we can ensure the treatment you have selected is safe for you to use

all of our tests and treatments are price competative

Need Help?

If you need help with this medical questionnnaire call us on 07549286701

 
quality products assured across youth revisited

Quality products

all of our tests and treatments are price competative

Affordable prices

all of our pharmacies and and treatments purchased are from well known and trusted UK pharmacies

UK pharmacy

all of our tests and any other products purchased will be dispatched for a next day service

Express next day delivery

If you have any further questions about any of our products please feel free to contact us and we will do our best to help you.
Once you have your prescription we will be able to process your order through our trusted UK Pharmacy.