UTI - Urinary Tract Infection aka Bladder Infection Online Prescription Questionnaire

We follow a rigorous process during all our online doctor consultations. Fill out our questionnaire to receive tailored healthcare just for you.

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Note: UTI infection is also known as bladder infection or urine infection. This platform is only for patients with mild symptoms. If you are unwell please see your GP or visit your nearest emergency department.

All (*) marked questions are mendatory

Are you experiencing any symptoms suggestive of urinary tract infection such as, burning sensation when passing urine, cloudy or rose coloured urine, increased frequency of urination?*

YesNo

Is there a chance that you might be pregnant?*

YesNo

I confirm that I am not taking any of the following medications: *

ACE inhibitors
Warfarin
Phenytoin/Digoxin/Procainamide
Any HIV medication
Dapsone
Rifampicin
Cyclosporin
Antacids
Uricosuric medications
Bone marrow suppressants
Probenecid
Metformin

YesNo

It's illegal to obtain a prescription for the use of another person. Will this be for your own personal use?*

YesNo

Consents *

I confirm that I understand the limitations of an online consultation and I am aware that this may not replace the need for a face to face consultation with my GP
I confirm that I take responsibility for informing my GP of this consultation and any subsequent health issues.If I have any concerns about any aspect of my health i will consult my regular GP
I confirm that I understand Panraa Clinics is not liable for damages which arise from my failure to inform my GP or other healthcare professional about treatment I receive from the website
I confirm that I agree to the website privacy policy and terms and conditions.I have read the refund policy in the FAQs section and I agree to this policy

I agree with all consents