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Acne Consultation
You must fill in the following form before you can purchase your Acne treatment
Acne Consultation
Have you previously been diagnosed with acne by either a GP or dermatologist during or following a face to face consultation?
- Select -
Yes
No
Which part(s) of your skin is affected by the acne?
Face
Chest
Back
Arms
Other
How long have you been suffering with acne?
Less than 1 month
Between 1 month and 3 months
More than 3 months
How does your acne present? (please select as many relevant options as possible)
Inflamed spots
Whiteheads
Blackheads
Tender lumps under the skin
Have you previously used any prescription treatments (including any topical retinoids) for your acne?
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Yes
No
Please provide more details
Have you ever been diagnosed with any other medical conditions?
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Yes
No
Please provide more details
Are you currently pregnant, planning a pregnancy or breastfeeding?
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Yes
No
Do you suffer with any allergies?
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Yes
No
Please provide more details
Do you currently take any medication? This includes herbal remedies and over the counter medication.
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Yes
No
Please provide more details
Is there any other information you would like to share with our prescribing team?
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Yes
No
Please provide more details
We strongly recommend that you inform your GP of any treatment you receive. Would you like WePrescribe to do this on your behalf?
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Yes
No
I have read and understood the
Terms and Conditions
.
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Yes
No
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Acid Reflux
Acne
Chlamydia
Contraceptives
Cystitis (UTI)
Eczema
Emergency Contraception
Erectile Dysfunction
Hair Loss
Hair Removal
Hayfever
Heavy Periods
Herpes
IBS
Malaria Prevention
Migraine
Nail Infection
Period Delay
Period Pain
Premature Ejaculation
Psoriasis
Stop Smoking
Thrush
Weight Loss
Video Consultation
How it works
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