____Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Which parts of your body are affected by excessive hair growth? *FaceNeckBackChestOtherPlease tell us where you experience excessive hair growth. *Vaniqa cream has only been demonstrated to be effective for use on the face and under the chin. If you have excess hair elsewhere that you want treated, you may need to look at other private treatments like laser hair removal therapy.We'd also recommend that you consider whether there is an underlying cause for excess hair growth, such as Polycystic Ovary Syndrome (PCOS) or high testosterone levels.Do you have any conditions affecting your kidneys or liver? *YesNoPlease give us more information about this. *Do you have any other medical conditions? *YesNoPlease list all your medical conditions: *Are you pregnant or breastfeeding? *YesNoPlease choose the relevant option. *I'm pregnantI may be pregnant, I'm not sureI'm breastfeedingAre you currently taking any medication, or have you recently finished a course of medication? *YesNoPlease list the names and doses of all these medications. *What do you use these medications for? * What’s this to Are you allergic to any medicines or other substances? | For example, peanuts or soya *YesNoWhat medicines or substances are you allergic to? *Checkboxes *The treatment available through this service must only be used for excessive hair growth on the face or neck areas. It is not suitable for use on any other areas of the body.Please tick to confirm that you understand and wish to continue with your assessment. *I fully understand the questions asked & have answered honestly and truthfully.I fully understand the side-effects of the treatment options, their effectiveness and alternative options & am happy to continue with my request.I confirm & agree that any treatment prescribed for me is for my personal use only. *Please tick here to signify that you have read, understand and agree to abide by our Privacy Policy. *NextYour request *Vaniqa cream11.5 (1x 60g tube)Telephone Consultation with a Doctor (does not include prescription medication): *(Only Phone Consultation)*PreviousNextWhat’s Your Birth Gender? *MaleFemaleName *FirstLastEmail *Phone *What’s Your Date of Birth? *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Select pharmacy for collection *674 Coventry Road, Small Heath, Birmingham, B10 0UU105 Barton Street , Gloucester, GL1 4HR267 Dewsbury Road, Leeds, LS11 5HZ41 Caldmore Green, Walsall, West Midlands, Walsall, WS1 3RWNationwide DeliveryYesPreviousNextDo you agree and consent to the following? You are completing this consultation for yourself and to the best of your knowledge. You will disclose any medical conditions, serious illnesses or operations you have had. You will disclose any prescription medications you are currently taking and agree to use only use one weight loss treatment at a time. You agree to our Terms & Conditions, Terms of Sale, and confirm that you have read our Privacy Policy. Your accurate and honest responses to this online questionnaire for weight loss treatment are crucial. Withholding or providing false information can severely harm your health and may result in life- threatening consequences. By filling out this questionnaire, you confirm that your responses are truthful and accurate, acknowledging the potential risks of misinformation. *Please confirm you understandPrivacy Policy *I have read, understand and agree to AllCare Pharmacy Online Doctor's Privacy PolicySubmit