Express Allergies prescription online

If you are an existing MobiDoctor user, then
If you are a new user, please before filling out the form

This questionnaire forms the basis of your Allergy consultation today. We need you to be honest with your answers including any current medication you are on. This allows our doctors to prescribe medication that helps you and offer accurate advice. We expect you to read the medicinal information provided before selecting your treatment.

You do not need to book a consultation after filling out the questionnaire

* Please answer all questions correctly so the doctor will be able to prescribe your medication

Have you been diagnosed with Allergy?

Yes NO

What symptoms do you experience?

Do you regularly suffer from sore or watery eyes, puffy eyes, itchy eyes, runny nose, blocked nose or bouts of sneezing?

Yes NO

Do your symptoms generally get better or worse when you spend time outdoors?

Yes NO

Is there any seasonal variation in your symptoms?

Yes NO

Do you experience breathing problems?

Yes NO

Do your breathing problems get worse when you're around tobacco smoke, fumes or strong odors?

Yes NO

Do you get in contact with animals?

Yes NO

Please give details if symptoms worsen or not.

Do you experience any symptoms after consumption of dairy products or any kind of food?

Yes NO

Do you smoke?

Yes NO

Are you using any medications for Allergy?

Yes NO

Have you experienced any side effects while using medications for allergies?

Yes NO

Are you suffering from any other medical conditions?

Yes NO

Do you have any allergies to medicines or other substances?

Yes NO

Do you have history of drug reactions in the past?

Yes NO

Do you understand the possible side effects of these medication?

Yes NO

Do you have any preferred medication you wish to get prescribed?

Yes NO

Which country are you currently in?

Do you have private health/travel insurance and need a reimbursement form? +€10

Yes NO

I confirm I am over 18 years old and this treatment is for myself and no other patients. The medicine ordered is for my sole use only. I will read the patient information leaflet supplied with the medicine specifically the side effects and dosages. I take responsibility to inform my own regular doctor of the online consultation or any changes in my circumstances. I agree to the terms and conditions.

Agree to Terms

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