Hair Loss

____

Please enable JavaScript in your browser to complete this form.

Have you been diagnosed with Androgenic Alopecia (Male Pattern Baldness)?

Yes, by my GP
Yes, by a specialist
No, self-diagnosis

Please choose your hair pattern. *

A
B
C
D
E
No pattern fits well

Please upload 2 photos clearly showing your hair pattern.

Click or drag a file to this area to upload.

Checkboxes

From the hair distribution image that you've selected, your hair loss may be quite extensive. In this case it is unlikely that this medication will lead to a significant improvement in your hair distribution. It is also possible that the side effects or possible risks of treatment may outweigh any benefits.

Please tick to confirm if you would like to continue with the assessment.

Are you currently using finasteride (or the brand Propecia)?

Are you finding it effective? Have you had any side effects?

Have you taken finasteride or Propecia for hair loss before?

Was it effective? Did you have any side effects?

When did you first notice any hair loss?

In the last month
More than a month ago

How did your hair loss start?

Suddenly
Gradually (over months)

Do you think your hair loss could be due to any other causes?

Can you give more details about how your hair loss started?

Have you noticed any other changes to the areas where you are losing hair?

Such as redness, itching, flaking or soreness

These symptoms suggest there could be other causes contributing to your hair loss, other than male pattern hair loss, which may improve with other treatments. We'd suggest you see your GP first to consider any other causes before taking this medication.

Please describe the all changes that you've noticed

Can you always get and maintain an erection when you want one?

One of the side effects of finasteride and Propecia, which occurs in around 2% of men, is problems with sexual function, including erectile dysfunction, meaning your symptoms of ED may worsen.

Do you have, or have you had, any of the following conditions?

Prostate cancer
Breast cancer
Liver condition
Any type of skin conditions
None of the above

Do you have any other medical conditions not mentioned above?

Please provide more details

Are you currently taking any medication, or have you recently finished a course of medication?

Please list the names and doses of all these medications?

pattern. Your questionnaire,

What do you use these medications for?

Are you allergic to any medicines or other substances?

For instance peanuts or soya.

What allergies do you have?

Finasteride
Peanuts or Soya
Lactose
Other medications
Other substances

Checkboxes *

Some people when taking this medication have experienced severe depression. You should stop taking this medication immediately if you notice that your mood is affected and speak to your doctor. Please tick if you understand this and wish to continue. You can send us a message on your account if you have any questions about this *
Please tick to acknowledge that it is best practice to inform your GP of any private treatment you receive. All treatment and messaging is completely confidential. However, you can easily update your GP by downloading a GP letter from the ‘Order History’ section of your account and sending it to them. If you prefer, we can send this letter directly to your GP, just send us their details *
I fully understand the questions asked & have answered honestly & 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. *

Your Request

Finasteride 1mg - (1 month - Generic Treatment) (28 tablets) - £27.00
Finasteride 1mg - (2 months - Generic Treatment) (56 tablets) - £54.00
Finasteride 1mg - (3 months - Generic Treatment) (84 tablets) - £79.00
Finasteride 1mg - (6 months - Generic Treatment) (168 tablets) - £137.00
Propecia 1mg - (1 month) (28 tablets) - £54.00
Propecia 1mg - (2 months) (56 tablets) - £97.00
Propecia 1mg - (3 months) (84 tablets) - £118.00
Propecia 1mg - (6 months) (168 tablets) - £215.00
Telephone Consultation with a Doctor (does not include prescription medication): Available 2-3pm Friday (Only Phone consultation) - £25.00

What’s Your Birth Gender? *

Male
Female

Name *

First

Last

Email *

Phone *

What’s Your Date of Birth? *

Select pharmacy for collection *

674 Coventry Road, Small Heath, Birmingham, B10 0UU
105 Barton Street , Gloucester, GL1 4HR
267 Dewsbury Road, Leeds, LS11 5HZ
41 Caldmore Green, Walsall, West Midlands, Walsall, WS1 3RW

Do 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 understand

I have read, understand and agree to AllCare Pharmacy Online Doctor's Privacy Policy

____

Birmingham

Gloucester

Leeds

Walsall