Mon - Fri: 9:00 - 17:00
01493 600610

NHS
Private
Vaccine
Travel
Ear
Shop

NHS
Private
Vaccine
Travel
Ear
Shop

Clenil inhaler consultation

To place an order, fill out the consultation questionnaire correctly.
One of our clinicians will review your order and prescribe a suitable treatment.
You will only be charged if treatment is prescribed.

Clenil consultation (#45)

Caution: This is NOT an emergency service for asthma and is not intended to replace regular reviews and monitoring with your GP.

Please contact 999 or visit A&E if you are suffering from acute breathlessness, wheeze or chest tightness.

First Name

Last Name

Date of birth

Phone number

Address

Postcode

Is the shipping address the same as above?

Yes

What is your shipping address?

Have you been formally diagnosed with asthma?

Yes

Why do you need asthma treatment?

I have exercise induced asthma

I have allergic or seasonal asthma

Other reasons

Please provide details

Why are you requesting treatment today?

My inhaler has run out

I need a spare inhaler

To replace a lost or broken one

Other reasons

Please provide the reason:

Do you usually use a blue inhaler (reliever) for your asthma?

Yes

What is the name of the blue inhaler?

Salbutamol inhaler

Ventolin inhaler

Other

Please provide detail:

Why don't you use a reliever inhaler for your asthma?

Do you usually use a brown inhaler (preventer) for your asthma?

Yes

What is the name of the brown inhaler?

How many times do you use this every day?

Do you use any other treatment for your asthma?

Yes

Please provide details

In the last month, how often have you been woken up at night by your asthma?

Once or more nights per week

Rarely or never

In the last month, how often have you had your usual asthma symptoms during the day?

Rarely or never

Less than 3 days a week

3 or more days a week

In the last 12 months, have you been to hospital as an emergency because of your asthma?

Yes

Have you seen your GP about your asthma since you were in hospital?

Yes

When did you last see your GP or nurse for a review of your asthma?

In the last 12 months

More than 12 months ago

Not sure

Do you have any other medical conditions?

Yes

Please provide details

Are you allergic to any medication?

Yes

Please provide more information

Are you pregnant or breastfeeding?

Yes

Please provide more information

We strongly recommend that you inform your GP of any treatment you receive. Would you like us to do this on your behalf?

Yes

Please provide us your surgery name and email address

You understand the following:

My responses are honest and accurate which are necessary for a safe medical assessment.

I fully understand the side effects of the treatment options, their effectiveness and alternative options & I'm happy to continue with my request.

I confirm & agree that any treatment prescribed for me is for my personal use only.

I have read and agree to the Terms and Conditions, Delivery & Return Policy and Privacy Policy

Prescription (official use only)

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Online Chemist in Gorleston, an NHS online pharmacy and travel vaccine clinic

Online Chemist
82 Middleton Road
Gorleston
Great Yarmouth
Norfolk, NR31 7AH
Phone: 01493 600610
Email: info@onlinechemistuk.net

Superintendent Pharmacist:
Obaidullah Zaman
BPharm, MPharm, PGDip (Pharmacy), MRPharmS, IP
GPhC Reg. Number: 2083409

Pharmacy Premises GPhC Reg. Number: 9011159

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NHS online pharmacy Gorleston Great Yarmouth Norfolk

OPENING HOURS

Monday 09:00 – 17:00
Tuesday 09:00 – 17:00
Wednesday 09:00 – 17:00
Thursday 09:00 – 17:00
Friday 09:00 – 17:00
Saturday Closed
Sunday Closed

Click here for driving directions

Online Chemist is a trading name of Nomaz Limited.
Registered in England – 11349276.