Contraception Oral or Patch

1. I understand the questions above and have answered honestly. 
2. I understand that any inaccurate or false information could potentially be dangerous to my health and safety.
3. The medication that is prescribed is for my personal use only. I understand the side effects and effectiveness of the treatments.
4. I agree to the Terms & Conditions of this platform.
5. I am 18 years or older.
6. I am currently living in South Africa.

Please remember the following when using contraceptive medications

• 💊 Oral & Patch contraceptives are over 99% effective in preventing pregnancy when used as prescribed. It's crucial to take your pill daily as directed. If you miss a pill, follow the instructions on the medication pamphlet.
• 😷 Common side effects include nausea, mood changes, weight fluctuation, and changes in menstruation. Most are mild and should subside over time. However, please urgently visit your nearest emergency department if you experience severe symptoms like intense headaches, chest pain, leg swelling or prolonged bleeding as they can indicate rare but serious conditions.
• 🍌 It's important to note that while effective for pregnancy prevention, hormonal contraceptives do not protect against sexually transmitted infections (STIs). Please use barrier methods such as condoms for STI protection.
• 🚭 Please do regular breast examinations, regularly monitor your blood pressure and avoid smoking. Smoking while on hormonal contraception can further increase your risk of blood clots. Please also remember to have regular pap smears for safety.

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

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.