Before you begin: your answers are reviewed by a UK-registered prescriber and kept confidential. Please answer honestly and in full — it's what keeps your treatment safe. Do you understand and agree to answer honestly?
What is your sex registered at birth?
How old are you?
What do you need to delay your period for?
How long would you like to delay your period?

Norethisterone can usually delay a period for up to around 17 days; longer than this isn't recommended.

Do you know roughly when your next period is due?

Norethisterone is usually started about 3 days before your period is due.

Are you pregnant, breastfeeding, or is there any chance you could be pregnant?
Are you allergic to, or have you ever reacted badly to, norethisterone?
Do you, or a close family member, have a history of blood clots (DVT or pulmonary embolism), or a known clotting disorder (thrombophilia)?
Do any of these currently apply to you?

These can all add to the risk of a blood clot, so the prescriber needs to weigh them up.

Have you ever been diagnosed with any of the following?
Are you currently taking any medicines (prescription or over-the-counter), supplements, or recreational drugs?
Are you currently using any hormonal contraception (e.g. the pill, patch, implant, injection or hormonal coil)?

If you take the combined pill there may be a simpler way to delay your period — the prescriber will advise.

Are you taking any of these?
You understand that norethisterone here is only for delaying your period, and that if you want it for any other reason you should see your doctor, as a different treatment may be more suitable. Do you understand?
You understand that norethisterone for period delay does not work as a contraceptive, so you should keep using your usual contraception if you need to. Do you understand?
You understand you should stop the medicine and seek urgent medical help if you get possible signs of a blood clot — such as painful swelling in a leg, chest pain, or sudden breathlessness. Do you understand?
Is there anything else you'd like to tell the prescriber?
Please confirm all of the following: you will read the patient information leaflet supplied; the treatment is for your use only; you have answered every question truthfully and accurately; you will tell us and your GP if you get side effects, start new medicines, or your health changes; and you agree to our terms & conditions, privacy policy and acceptable-use policy.
Do you consent to us informing your NHS GP that you have started this treatment?

We think it’s safest to keep your regular GP in the loop about your care. If you don’t consent, we’re unable to continue with this treatment.

Which is your GP practice?

Start typing your surgery name or postcode and pick it from the list.

Can’t find your practice? Enter it manually

Do you agree to OnlineUKPharmacy accessing your GP Summary Care Record if the prescriber needs to?
I understand that if this treatment is not suitable I will be refunded and signposted to appropriate care, and that the final prescribing decision always rests with the prescriber.