Are you aged between 18 and 65?

Have you already been diagnosed with Cold Sores?

<ul>
<li>Sores or lumps in the mouth lasting for more than 3 weeks</li>
<li>Painful red and white patches on the inside of the mouth</li>
<li>Unable to swallow liquids</li>
<li>Severe headaches or vomiting</li>
</ul>

Do you have any of the following symptoms?

Are you experiencing 6 or more outbreaks per year, or are the outbreaks causing you psychological distress or affecting your social life?

Have you ever experienced an adverse reaction, or an allergic reaction, to any medicines containing Aciclovir, Famciclovir, Penciclovir, or Valaciclovir?

Are you breast feeding, pregnant or possibly pregnant, or trying to become pregnant?

Do you suffer with any problems with your kidneys, urinary system, digestive system, your liver, central nervous system or any other serious medical condition that may require you to be hospitalised?

<p style="font-size: 14px">*You are advised to inform your regular Doctor about any treatment you receive from us</p>

Would you like your Doctor to be informed of this consultation?*

This does not automatically exclude treatment if you refuse to share or consent — answering 'No' does not automatically exclude you.

Do you consent to us informing your Doctor about any treatment prescribed through this service?

Do you reside in England?

Please confirm that you consent to us accessing your summary care records from your GP.

Please confirm that you understand the questions asked and have answered them honestly. This treatment is for you only. You should read the patient information leaflet that comes with your medicine and send us a message if you have further questions.

<ul>
<li>Will read the patient information leaflet supplied with each box of medication</li>
<li>This request for treatment is for your own personal use</li>
<li>Have answered the above questions correctly and truthfully</li>
<li>Understand that prescribing decisions are based on the accuracy of your responses and that providing incorrect information increases the risk of you experiencing serious side effects</li>
<li>Accept our <a href="https://www.frommars.com/uk/terms-of-use" target="_blank" rel="noopener">Terms of Use</a>, <a href="https://www.frommars.com/uk/terms-of-service" target="_blank" rel="noopener">Terms of Service</a> and <a href="https://www.frommars.com/uk/privacy-policy" target="_blank" rel="noopener">Privacy Policy</a></li>
</ul>

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