Irritable Bowel Syndrome (IBS)

1. About your Health

To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.

Have you previously had a transient ischaemic attack (mini stroke) or stroke?

Yes

Do you suffer from any allergies?
If you do, kindly explain them below

Yes

Are you currently receiving any treatment or under any medication?
Please provide more information of the medication being used if any.

Yes

2. About your IBS

To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.

Women only: Are you pregnant or is there a possibility you may be pregnant?

Yes

Women only: are you currently breast-feeding?

Yes

Do you have inflammatory bowel disease (ulcerative colitis, crohn's disease etc.)?

Yes

Do you have blood in your urine?

Yes

3. The Agreement and Consent

Please answer the following questions to help us confirm that you'll follow the guidelines for this medicine.

Do you agree to the following?

You will read the patient information leaflet supplied with your medication.

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.

The treatment is solely for your own use.

You have answered all the above questions accurately and truthfully.

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.

Yes

Can we share this information with your General practitioner?
Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advice you share this treatment with your doctor for him/her to update your medical records.

Yes

Irritable Bowel Syndrome (IBS)

About our Pharmacy

Registration Detail

Contact Details

Our Services

Conditions

Opening Hours

Irritable Bowel Syndrome (IBS)

About our Pharmacy

Registration Detail

Contact Details

Our Services

Conditions

Opening Hours

Login Details

Please Register as a New Patient

Forgot Password ?