Assessment

Are you aged between 18-60 years old?

Please enter your date of birth

Have you been diagnosed with oral herpes (HSV1) by your GP or sexual health clinic?

Can you provide your symptoms?

Do you understand that you should drink water regularly while taking these medications?

Are you aware you should maintain hygiene and refrain from sexual contact while you have an outbreak of herpes?

Are you displaying any of the following symptoms?

• Unexplained weight loss
• Blood in your urine or stools chest pain fever pain when urinating
• Urinary tract infection
• Night sweats

Do you have any known allergies to any medicines or substances?

At which site(s) does the herpes infection affect you?

Please provide more information

We strongly advise that you inform your GP of any medication you receive

Would you like us to inform your GP of medication you receive from Rightdose?

Please enter your:

• Full Name
• Date of Birth
• Your registered home address with your GP

Please enter your:

• GP Surgery Name
• GP Surgery Address
• GP Surgery Email
• GP Surgery Contact Number

I confirm:

• I am over 18 years old
• The medicine ordered is for my sole use only
• I take responsibility to inform my own regular doctor of the online assessment or any changes in my circumstances
• I will read the patient information leaflet supplied with the medicine specifically the side effects and dosages
• I have answered all the questions truthfully
• I agree to the Rightdose online pharmacy privacy policy and terms and conditions