Two per customer
1) Could we please have the name and physical address of the patient, if not already provided, or if you are ordering for someone else?
2) Have you or the patient had this product before?
3) Could we please have your date of birth/age?
4) If applicable, are you pregnant or breastfeeding? If so, at what stage?
5) Are you (or the patient using this medicine) on any medications or have any health conditions?
6) This medicine is only licensed for SEVERE COLD SORES. please confirm this is what it is being used for?
7) What are you symptoms, if applicable?
8) Any allergies to medications?
Qty
An antiviral medicine for the treatment of recurrent outbreaks of cold sores that works by reducing the ability of the virus to reproduce.
