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

NHS
Private
Vaccine
Travel
Ear
Shop

NHS
Private
Vaccine
Travel
Ear
Shop

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Rosacea consultation

Rosacea Consultation

Patient details

Please complete the consultation as accurately as possible.

Are you completing the consultation for yourself?

Yes

Who are you ordering for? Please give details

First Name

Last Name

Date of birth

Address

City

Postcode

Is the shipping address the same as above?

Yes

What is your shipping address?

Have you been diagnosed this condition by a GP or dermatologist?

Yes

How would you describe your rosacea?

Mainly flushing or redness

Mainly spots or bumps

Other symptoms

Please describe your rosacea symptoms:

Have you tried any products to treat your rosacea?

Yes

Which treatments have you tried?

Rozex gel (Metronidazole)

Mirvaso gel (Brimonidine)

Azelaic acid (Finacea)

Soolantra

Oral antibiotics

Other treatments

How long for and did it improve your symptoms?

Do you have any other medical conditions, including skin conditions?

Yes

Please provide details

Are you taking any other prescription-only medicines, over-the-counter medicines, alternative medicines or recreational drugs?

Yes

Please provide details

Do you have any known allergies?

Yes

Please provide details

Do you have any conditions affecting your liver or kidney?

Yes

Please provide details

Are you currently pregnant or breastfeeding, or planning to have baby?

Yes

Please provide details

Are you currently registered with a UK GP practice?

Yes

Please provide details

Photo upload

Please upload at least 2 photos of affected areas - one close-up and the other from distance.

Caution:
Please do not upload photos of private parts.

By uploading photographs you are consenting to store your photos securely in your medical records.

Upload image

Consent

I consent to the Online Chemist accessing my NHS summary care record (SCR) to process my treatment, if needed

I consent to have Online Chemist store my submitted information so they can respond to my inquiry.

Official use only

Experiences Shared by Our Customers

Don’t simply rely on our claims, become part of the delighted community of thousands of customers who are experiencing the remarkable benefits!

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.

Rosacea consultation

Patient details

Photo upload

Please upload at least 2 photos of affected areas - one close-up and the other from distance.

Caution:Please do not upload photos of private parts.

Experiences Shared by Our Customers

OPENING HOURS

Caution:
Please do not upload photos of private parts.