Consultation | Mentor Pharmacy

1 Contraception

This consultation ensures that the contraception you are purchasing is safe, effective, and suitable for your individual health needs. By answering the following questions, you provide essential information to assess your eligibility for the medication. The process is quick, confidential, and designed to help you make an informed decision about your contraceptive options.

Form questions missing!

2 About Your Health

In this phase, we gather details about your general health to identify any potential risks or contraindications related to contraceptive use. This includes questions about allergies, medical history, and current medications. Your responses help ensure the medication is safe and suitable for your overall health.

Are you a female?

Yes

Are you allergic to norethisterone or any other similar hormone medicines?

If yes, please detail them here, otherwise please type N/A

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

Yes

Are you currently taking any other medicines including any herbal remedies? (e.g. St. John's Wort)

Have you ever been advised against using hormonal contraception by a healthcare provider?

Yes

3 About Your Condition

This phase focuses on your specific contraceptive needs and any factors that might influence the effectiveness or safety of the medication. Questions include your reasons for seeking contraception, previous use of contraceptives, menstrual cycle regularity, and any recent symptoms or health concerns. This helps tailor the medication to your unique circumstances.

What type of contraception are you interested in?

What is your primary reason for seeking contraception?

Preventing pregnancy, managing menstrual cycle irregularities or if other please specify.

If you have chosen "Other (please specify)" for your reason for seeking contraception, please specify here.

Do you have a history of sexually transmitted infections or concerns about your sexual health?

Yes

Have you previously used any form of contraception?

Do you have a regular menstrual cycle?

Yes

Have you experienced any unusual symptoms, such as abnormal bleeding, severe abdominal pain, or unexplained weight changes?

Have you had a recent check-up with a healthcare provider regarding contraception?

Yes

4 The Agreement and Consent

Please take the time to carefully read the Agreement and Consent statements during our online consultation process. Understanding these statements is essential for your safety and for ensuring that you are fully informed about the treatment you will receive. The Agreement and Consent sections outline important information about the risks, benefits, and responsibilities associated with your medication. By reading and agreeing to these terms, you help us ensure that you are aware of and comfortable with the treatment plan. Your informed consent is crucial for providing you with the best possible care. Thank you for your cooperation and trust in our services.

Do you agree to provide accurate and truthful information in this assessment?

Yes

Do you understand that the information provided will be reviewed to ensure the medication is safe and suitable for you?

Yes

Do you consent to the processing of your information for the purpose of this purchase, in compliance with data protection regulations?

Yes

Do you confirm that you will seek medical advice if your symptoms persist, worsen, or if you experience side effects from the medication?

Yes

Assessment for Contraceptives

1 Contraception

2 About Your Health

Are you a female?

Are you allergic to norethisterone or any other similar hormone medicines?

Yes

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

Are you currently taking any other medicines including any herbal remedies? (e.g. St. John's Wort)

Yes

Have you ever been advised against using hormonal contraception by a healthcare provider?

3 About Your Condition

What type of contraception are you interested in?

What is your primary reason for seeking contraception?

If you have chosen "Other (please specify)" for your reason for seeking contraception, please specify here.

Do you have a history of sexually transmitted infections or concerns about your sexual health?

Have you previously used any form of contraception?

Yes

Do you have a regular menstrual cycle?

Have you experienced any unusual symptoms, such as abnormal bleeding, severe abdominal pain, or unexplained weight changes?

Yes

Have you had a recent check-up with a healthcare provider regarding contraception?

4 The Agreement and Consent

Do you agree to provide accurate and truthful information in this assessment?

Do you understand that the information provided will be reviewed to ensure the medication is safe and suitable for you?

Do you consent to the processing of your information for the purpose of this purchase, in compliance with data protection regulations?

Do you confirm that you will seek medical advice if your symptoms persist, worsen, or if you experience side effects from the medication?

Assessment Progress

Quick Links

Assessment for Contraceptives

1 Contraception

2 About Your Health

Are you a female?

Are you allergic to norethisterone or any other similar hormone medicines?

Yes

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

Are you currently taking any other medicines including any herbal remedies? (e.g. St. John's Wort)

Yes

Have you ever been advised against using hormonal contraception by a healthcare provider?

3 About Your Condition

What type of contraception are you interested in?

What is your primary reason for seeking contraception?

If you have chosen "Other (please specify)" for your reason for seeking contraception, please specify here.

Do you have a history of sexually transmitted infections or concerns about your sexual health?

Have you previously used any form of contraception?

Yes

Do you have a regular menstrual cycle?

Have you experienced any unusual symptoms, such as abnormal bleeding, severe abdominal pain, or unexplained weight changes?

Yes

Have you had a recent check-up with a healthcare provider regarding contraception?

4 The Agreement and Consent

Do you agree to provide accurate and truthful information in this assessment?

Do you understand that the information provided will be reviewed to ensure the medication is safe and suitable for you?

Do you consent to the processing of your information for the purpose of this purchase, in compliance with data protection regulations?

Do you confirm that you will seek medical advice if your symptoms persist, worsen, or if you experience side effects from the medication?

Assessment Progress

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