Bacterial Vaginosis

1. I understand the questions above and have answered honestly. 
2. I understand that submitting any inaccurate or false information could potentially be dangerous to my health and safety.
3. Treatment is prescribed as per South African medical guidelines. There is no guarantee that the treatment will be 100% effective for you. Please consult with our online doctors or visit an in-person doctor if you are still symptomatic or not improving.
4. The medication that is prescribed is for my personal use only. I understand the side effects and effectiveness of the treatments.
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6. I am 18 years or older.
7. I am currently living in South Africa.
8. Please note that ID verification is required for all patients
9. I acknowledge that a doctor will communicate with me via WhatsApp within 24 hours.
10. I confirm that the contact information I have provided is correct and belongs to me. I understand that the platform relies on this information to communicate private healthcare information with me.

Consent:

• Purpose of Treatment: To treat bacterial vaginosis (BV)

• Expected Outcomes: Symptoms such as discharge, odor, or discomfort should improve within a few days. Completing the course helps prevent recurrence. Some women may need repeat or alternative therapy if BV returns.

• Possible Side Effects:

Metronidazole:

• • Nausea, metallic taste, stomach upset, diarrhea
  • Headache or dizziness
  • Rare: allergic reaction (rash, swelling, difficulty breathing), seizures, liver problems (seek urgent care if severe symptoms occur)

Fluconazole:

• • Headache, nausea, stomach upset
  • Rare: liver toxicity, skin rash, allergic reaction, palpitations
  • May interact with other medicines

• Precautions:

• • • Do not drink alcohol during and for 48 hours after treatment. Do not use if you are pregnant, breastfeeding, or have liver disease.
    • Avoid sexual intercourse or use condoms during treatment, as BV can recur or worsen.
    • Seek urgent care if you experience persistent abdominal pain, fever, or abnormal bleeding.

• Alternatives:

• • Topical (vaginal gel) metronidazole
  • Clindamycin cream or tablets
  • Watchful waiting (not recommended for symptomatic BV)
• Always read the medication leaflet for full instructions and possible side effects.

Submitting this questionnaire with any “⛔ (do not proceed)” conditions will disqualify you from receiving a prescription.

⛔Please urgently visit your nearest emergency dept or in-person doctor if you are experiencing symptoms such as severe pain, chest pain, difficulty breathing, allergic reactions, dizziness, weakness, or other severe symptoms. Telemedicine services are not suitable for emergency medical conditions.

If you require an invoice for medical aid, please fill out the below

Submitting this clinical form with any “⛔ (do not proceed)” conditions will disqualify you from receiving a prescription.

Please urgently visit your nearest emergency dept or in-person doctor if you are experiencing symptoms such as severe pain, chest pain, difficulty breathing, allergic reactions, dizziness, weakness, or other severe symptoms. Telemedicine services are not suitable for emergency medical conditions.