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Are you currently going through menopause?
Can you let us know why do you require hormone replacement therapy?
For further information kindly contact our patient support team:
0207 867 3932
email help@clickpharmacy.co.uk.
Which symptoms of menopause do you suffer from?
When was your last period?
Have you ever been prescribed hormone replacement therapy?
Please provide the name, dosage and when were you lastly prescribed that medication.
Have you had your womb (uterus) removed, also known as hysterectomy?
Do you agree to undergo the following checks regularly
Are you a smoker?
What was your most recent blood pressure reading?
What is your ethnicity?
Please state your height and weight:
Are you allergic to any medicines or other substances?
Can you please provide more details?
Does any of the following apply to you?
Are you taking any medication (prescription or over the counter)
Please provide the name, dosage and the reason why you are taking that medication or medications
Do you agree to the following?
Please tick the boxes to confirm the following:
Don't have an account?
Already have an account?
Gender:
Date of birth