Urinary Tract Infection (UTI | Cystitis) – Express Prescription

Name

Surname

Phone Number

ID Number

Have you used our services before?

Address

City

Postal Code

Are you female?

Are you 18 years or older?

Did your UTI symptoms start less than 7 days ago?

Do you get UTIs more than 3 times per year?

Do you have kidney disease or are undergoing dialysis?

Do you have any allergies to Fosfomycin (antibiotic)?

Are you pregnant or breastfeeding/ expressing breastmilk?

Do you have any of these medical conditions?

Have you received a prescription for Fosfomycin in the last 7 days?

I have read and agree to the Terms and Conditions and Privacy Policy (POPI) of the use of this Website and Service. I understand the questions above and have answered honestly. I understand that any inaccurate or false information could potentially be dangerous to my health and safety. The medication that is prescribed is for my personal use only. I understand the side effects and effectiveness of the treatments.I agree to the Terms & Conditions of this platform.I am 18 years or older.I am currently living in Zimbabwe

I Agree to the terms and conditions of this Prescription Application and that of the use of this service.

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US$ 10,00