Do you agree and consent to the following?

  1. You are completing this consultation for yourself and to the best of your knowledge.
  2. You will disclose any medical conditions, serious illnesses or operations you have had.
  3. You will disclose any prescription medications you are currently taking and agree to use only one weight loss treatment at a time.
  4. You agree to our Terms & Conditions, Terms of Sale, and confirm that you have read our Privacy Policy.
  5. Your accurate and honest responses to this online questionnaire for weight loss treatment are crucial. Withholding or providing false information can severely harm your health and may result in life-threatening consequences. By filling out this questionnaire, you confirm that your responses are truthful and accurate, acknowledging the potential risks of misinformation.
  6. You agree to undergo identification and age verification. This may require submitting valid documents to our approved third-party verification partner for validation.
  7. You consent to EveryDayMeds accessing your Summary Care Record (SCR) for the purpose of ensuring the safe supply of treatment. If the SCR is unavailable or incomplete, you agree to participate in appropriate two-way communication (e.g. phone, secure message, or video consultation) to verify your medical history. If you do not respond or engage, your order will be cancelled.

Your Health

Medical Condition

  • Liver problems
  • Kidney problems
  • Immunodeficiency (e.g. HIV, autoimmune disease)
  • Abnormal blood count
  • Organ transplant recipient
  • Warts cover an area larger than 4 cm²
  • Reduced haematologic reserve
  • Any serious condition that may require hospitalisation
  • Unintentional weight loss
  • Blood in urine or stools
  • Painful urination
  • Frequent UTIs
  • Night sweats or fever
  • Bleeding from the anus or urethra
  • Discharge from the wart, penis, or vagina
  • Swollen lymph nodes
  • Abnormal urine flow
  • Changes in appearance of warts since diagnosis
  • Warts located internally (vagina, urethra, cervix, rectum, or anus)
  • Anal warts
  • Open sores, broken skin, or ulcers around warts
  • Bleeding between periods or after sex (for women)
  • Warts on the foreskin
  • You’ve had the same outbreak for more than 18 months
  • Warts larger than 4 cm²

Medication

Agreement

  • You will read the patient leaflet with your medication
  • You will inform your GP of any side effects or changes
  • The treatment is for your personal use only
  • You have answered the questions truthfully
  • You understand our prescribers rely on your answers
  • Final prescribing decisions are made by the prescriber

GP Consultation

We can notify your GP of your treatment for you. To do so, we need their contact information. Sharing this information allows your GP to maintain a comprehensive record of your medical history, which is crucial for your health. Without complete records, there could be potential risks to your well-being.