Consultation - The Care Pharmacy

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Which country (or countries) are you travelling to

Please be as detailed as possible

What areas or regions within that country will you visit?

Please be as detailed as possible

Departure date:

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Return date:

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Will you be staying in rural areas?

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Are you travelling for work, holiday, or visiting family/friends?

Please be as detailed as possible

Have you used malaria prevention tablets before?

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If yes, which one and did you have any problems with it?

Do you have any known allergies to medicines (especially antimalarials)?

Choose Option

If yes, please specify:

Are you pregnant, planning pregnancy, or breastfeeding?

Select Option

Do you have any medical conditions, including:

Tick all that apply

Are you taking any regular medicines, including antibiotics or contraceptive pills?

Choose Option

Yes

Do you understand the following?

Do you understand?

Which country (or countries) are you travelling to

Please be as detailed as possible

What areas or regions within that country will you visit?

Please be as detailed as possible

Departure date:

Pick a date

Return date:

Pick a date

Will you be staying in rural areas?

Choose Option

Are you travelling for work, holiday, or visiting family/friends?

Please be as detailed as possible

Have you used malaria prevention tablets before?

Choose Option

If yes, which one and did you have any problems with it?

Do you have any known allergies to medicines (especially antimalarials)?

Choose Option

If yes, please specify:

Are you pregnant, planning pregnancy, or breastfeeding?

Select Option

Do you have any medical conditions, including:

Tick all that apply

Are you taking any regular medicines, including antibiotics or contraceptive pills?

Choose Option

Yes

Do you understand the following?

Do you understand?

Add your WhatsApp Number

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Excellent!