Genital Herpes

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. 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.
5. I agree to the Terms & Conditions of this platform.
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.

Consent:

• Purpose of treatment: These medicines are antiviral drugs. They control the herpes virus, shorten the length of an outbreak, reduce symptom severity, and help prevent recurrences. They do not cure herpes or eliminate the virus completely.

• How to take the medication:

• • • Use as per instructions.
    • Take with or without food, but drink plenty of water to protect your kidneys.
    • Try to take the doses at the same times each day.
    • If you miss a dose, take it as soon as you remember unless it’s nearly time for your next dose (do not double up).
• Safety and precautions: Inform your doctor if you have kidney problems or are on other medications. Not a cure - the virus can still be passed on to others even without visible sores (asymptomatic shedding). Always use condoms to reduce transmission risk, especially if sores are present. Avoid sexual contact during an outbreak to prevent infecting your partner.

• Possible side effects may include:

• • • Common: Headache, nausea, stomach pain, dizziness, tiredness.
    • Less common: Skin rash, itching, diarrhoea.
    • Seek urgent care if you experience confusion, hallucinations, difficulty urinating, or allergic reaction (swelling, difficulty breathing).
  • Inform partners so they can make informed choices about protection.

• When to seek further medical help: 

• • • If outbreaks become more frequent or severe despite treatment.
    • If you develop severe side effects.

• 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.