Important

This questionnaire forms the basis of your online consultation. Please be honest and if you are unsure about any of your answers, please verify the information with your GP before using the service:

I am 18 years old or above.
I am using this service on my own behalf and of my own free will. Any treatment or advice is for my sole use only.

I confirm the above statements are true

This service is for genital herpes only. For wart treatment click HERE.

Health

Your medical history

Do you have any condition that suppresses your immune system?

Yes

Have you ever been diagnosed with a kidney condition?

Yes

Pregnancy and breastfeeding

Are you pregnant or planning to become pregnant within the next six months?

How do I know if I'm pregnant?

Yes

Are you breastfeeding?

Yes

Consent

Informed consent

I have responded honestly and provided complete and accurate information that reflects my up to date medical history and information, so that the doctor can safely assess and advise me.
I fully understand all the questions and information provided. If I am unsure about any aspect of the service I will contact the Online Doctor before proceeding.
I understand the side effects, effectiveness and alternatives to the treatment I am requesting.
I understand the importance of notifying my GP about medicines and advice I may receive from this service so they can continue to provide safe medical care.
I understand this consultation will form part of my Online Doctor medical record and will be kept in line with the relevant retention period.
I have read, understand and agree to the latest terms and conditions and privacy policy.
If I have further questions in relation to my sexual health or wellbeing, I will contact my GP or healthcare professional.

I have responded honestly and provided complete and accurate information that reflects my up to date medical history and information, so that the doctor can safely assess and advise me.
I fully understand all the questions and information provided. If I am unsure about any aspect of the service I will contact Lloyds Online Doctor before proceeding.
I understand the side effects, effectiveness and alternatives to the treatment I am requesting.
I understand the importance of notifying my GP about medicines and advice I may receive from this service so they can continue to provide safe medical care.
I understand this consultation will form part of my Online Doctor medical record and will be kept in line with the relevant retention period.
I have read, understand and agree to the latest terms and conditions and privacy policy.
If I have further questions in relation to my sexual health or wellbeing, I will contact my GP or healthcare professional.

I have responded honestly and provided complete and accurate information that reflects my up to date medical history and information, so that the doctor can safely assess and advise me.
I fully understand all the questions and information provided. If I am unsure about any aspect of the service I will contact the Online Doctor before proceeding.
I understand the side effects, effectiveness and alternatives to the treatment I am requesting.
I understand this consultation will form part of my Online Doctor medical record and will be kept in line with the relevant retention period.
I have read, understand and agree to the latest terms and conditions and privacy policy.