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Premature Ejaculation Consultation
You must fill in the following form before you can purchase your Premature Ejaculation treatment
Premature Ejaculation
After penetration do you usually ejaculate within 2 minutes?
- Select -
Yes
No
Does premature ejaculation directly or indirectly cause you distress within your sexual relationships or within any other part of your life?
- Select -
Yes
No
Do you have any difficulty getting or maintaining an erection?
- Select -
Yes
No
Have you or do you suffer with any of the following symptoms?
- Select -
Yes
No
- Pain while ejaculating - Difficulty passing urine - Pain in the testes - Feeling faint or dizzy when standing up after sitting or lying down
Do you suffer from low blood pressure (below 90/50) or ever fainted or collapsed due to your blood pressure?
- Select -
Yes
No
Have you ever been diagnosed with any other medical conditions?
- Select -
Yes
No
This can include: -Immune system conditions such as HIV -Liver or kidney issues
Please provide more details
Do you suffer with any allergies?
- Select -
Yes
No
If so, please provide more information
Please provide more details
Do you currently take any medication? This includes herbal remedies and over the counter medication.
- Select -
Yes
No
If so, please provide more information
Please provide more details
Is there any other information you would like to share with our prescribing team?
- Select -
Yes
No
If so, please provide more information
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?
- Select -
Yes
No
I have read and understood the
Terms and Conditions
.
- Select -
Yes
No
Please see our terms and conditions here
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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
About us
Blog
Contact Us