Are you registered with a GP practice in the UK?

Do you give us consent to write to your GP for approval of this supply and to share information we hold about you?
(The information entered below in the medical assessment form will be treated with utmost confidentiality whilst being reviewed by the prescriber. It will also provide the prescriber with important information which will help them make an informed decision in deciding if the treatment is considered to be suitable for you).

Do you believe you have the capacity to make decisions about your own healthcare?

Are you aged between 18 and 65?

Are you taking tamiflu to treat a current flu outbreak?

Are you allergic to Tamiflu (oseltamivir)

Are you breast feeding or pregnant or planning to become pregnant in the next 6 months?

Have you been diagnosed with any of the following?

• asthma
• lung disease
• heart disease
• kidney disease
• liver disease
• neurological disease
• immune system problems
• any serious medical condition which may require immediate hospitalisation

Are you currently taking any medication (including over the counter, prescription or recreational drugs)?

Do you understand that tamiflu can be taken to prevent or treat flu?

• Be aware that for treating a current flu outbreak tamiflu has only been proven to be effective if taken within 48 hours of experiencing symptoms
• Tamiflu can be taken for up to 6 weeks to prevent seasonal outbreaks of the flu
• Tamiflu can be taken as a short course if you suspect exposure to the flu

Do you understand that tamiflu is not a substitute for the flu vaccine?

Do you understand you must seek medical attention, if after taking Tamiflu, your symptoms do not improve after a few days or if you experience changes in your mood or behaviour?

Do you understand that tamiflu is not effective for treating COVID-19 coronavirus?

Do you agree to the following?

• I confirm I am over 18 years old.
• 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.
• You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment.
• I consent to being contacted by telephone or email should the doctor or pharmacist require further information to assess my order.
• You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.
• You are aware you will be subject to an ID check to verify your ID via LexisNexis Risk Solutions.