Assessment

Please provide your date of birth.

Please provide your address that is registered with your GP.

Please provide your GP surgery address.

Do you understand Propecia (Finasteride) is for men between 18-65 only?

Do you understand women at child bearing age should not handle Propecia (Finasteride) to avoid absorption through the skin.

Do you understand Propecia (Finasteride) can take 6 months before results are visible?

Have you noticed that Propecia / Finasteride has been working to prevent hair loss or regrow your hair?

Do you have any known allergies to any medicines or substances?

Are you aware that some users of Propecia / Finasteride may experience depression or suicidal thoughts?

I am aware that I may receive any brand if I have ordered generic Finasteride. If you do have a specific brand please advise us , if unavailable Rightdose will contact you to advise and offer alternatives.

We strongly advise that you inform your GP of any medication you receive.

Would you like us to inform your GP of medication you receive from Rightdose?

Please enter your:

• Full Name
• Date of Birth
• Your registered home address with your GP

Please enter your:

• GP Surgery Name
• GP Surgery Address
• GP Surgery Email
• GP Surgery Contact Number

I confirm:

• I am over 18 years old
• The medicine ordered is for my sole use only
• I take responsibility to inform my own regular doctor of the online assessment or any changes in my circumstances
• I will read the patient information leaflet supplied with the medicine specifically the side effects and dosages
• I have answered all the questions truthfully
• I agree to the Rightdose online pharmacy privacy policy and terms and conditions