Patient Selection Step 1 / 3

This questionnaire is an important part of your medical assessment today. We ask that you are honest with your answers. Any information that you provide in this questionnaire is protected by the exact same patient-doctor confidentiality you would expect from seeing a doctor face to face.

1Please be advised that this service is not suitable for all patients experiencing hay fever or allergy symptoms.

We have safety criteria and checks in place to ensure clinical safety and we kindly ask that you answer all questions honestly.

I understand

2Who are you requesting this treatment for?

Please be aware that if this prescription is approved, it will be issued in the name of this account holder, and will include their personal details.

For myself For a child For someone else

3THIS SERVICE IS UNSUITABLE

This service is only suitable for individuals aged 17 and older. If you're seeking treatment for a child under 17, please book a video consultation instead.

If your child is over 17 years old, they must apply through their own account.

I understand

4THIS SERVICE IS UNSUITABLE

You cannot apply for a prescription on behalf of another adult.

If someone aged 17 or older needs a prescription, they must apply through their own account.

For any registration issues or questions, you can contact us at info@webdoctor.ie.

I understand