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OnlineDoc Treatment
Chlamydia Treatment
Only
€
23 per Script
Chlamydia Treatment
First Name
Last Name
Date of Birth
Email
Phone Number
Address
What is your gender?
*
Male
Female
Please specify the symptoms that you are experiencing?
*
Required
Vaginal discharge/penile discharge
Pain with urination
Pain, swelling, or itching of the penis or vulva
Pain with intercourse/painful ejaculation
Bleeding between periods or with intercourse
Abdominal and pelvic pain
Pain or swelling in the testes
Rectal pain, discharge, or bleeding
Non of the above
Is there a STI screening result that indicates you are positive for Chlamydia?
*
No
Yes
If Yes, Please specify:
Did you have an unprotected relation with someone who is positive for Chlamydia recently?
*
No
Yes
Do you have any past medical or surgical history that you want to mention to our doctor?
*
No
Yes
If Yes, Please specify:
If you are a female, are you pregnant? or planning to be pregnant? or breastfeeding?
No
Yes
If Yes, Please specify:
Are you allergic to any medication or any other substance?
*
No
Yes
If Yes, Please specify:
Please provide the name and address of the pharmacy where you'd like to pick up your medications.
I confirm that the answers I have provided for the above questions are true and accurate to the best of my knowledge.
*
I Confirm
I Do Not Confirm
I confirm and agree that any treatment prescribed for me is for my personal use only.
*
I Confirm
I Do Not Confirm
I fully understand the side-effects of the treatment options, their effectiveness and alternative options and am happy to continue with my request.
*
I Confirm
I Do Not Confirm
Proceed to Checkout
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