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.
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What is your biological gender?
Please select your option
Are you aware of how high or low your blood pressure is?
This could be from an examination by your doctor, a certified medical practitioner or self-examination.
If you are aware of your blood pressure condition, do you check with your doctor regularly to ensure it is under control?
Can you relate to any of the following statements?
You have or have had stomach or duodenal ulcers, as well as stomach or intestinal bleeding in the past.
Are you experiencing any of the following health issues?
You've had a heart procedure, a stroke, or a heart attack in the last five years.
Are you on any of the following medication?
Antibiotics.
Is walking or running difficult for you?
Did you know that:
A healthcare practitioner should assess any acute injuries.
Have you been advised to avoid strenuous exercise?
If yes, please provide the reason
Can you relate to any of the following?
You have an underlying medical condition
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.
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About your Erectile Dysfunction
Please answer the following questions to help us confirm that you'll follow the guidelines for this medicine.
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If you have a history of using any ED medication, did you suffer any side effects?
If you did, kindly describe the effects
Have you tried any erectile dysfunction medication before?
You can select one or more options
If you have tried ED treatments before, did you get any side effects? If yes, please let us know what you expreienced
Do you have an allergy to Sildenafil, Tadalafil or Vardenafil
Have you taken any ED treatments before?
Have you taken either Sildenafil, Tadalafil or Vardenafil
Have you been diagnosed with erectile dysfunction by a doctor?
Have you had a serious reaction to an ED medicine before?
If yes, please describe the product/reaction.
Do you have symptoms of depression and have not seen a GP?
If yes, please provide details
Do you have difficulty in getting or maintaining an erection?
Are you aware that erectile dysfunction can sometimes mask underlying medical conditions, so it is recommended that you agree to consult your doctor about this?
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