About You


Please provide your weight.



Please provide your height.


Do you smoke or drink?

Do you take any medication whether prescribed, over the counter, herbal/alternative or partake in any recreational drug use?

Do you have any allergies?

Have you been advised to avoid strenuous exercise?

Are you able to walk 3 miles or climb a set of stairs without pain in your chest?

Do you have any history of symptoms of anxiety or depression?


About your symptoms

Have you been diagnosed by your GP as having hay fever/allergic rhinitis?

Have you used this medication before?

Are you currently suffering from symptoms of hay fever?

Which of the following symptoms do you usually experience?

What causes your symptoms?

Are you pregnant or breast feeding?

Do you understand that should you experience any of the following symptoms you should stop taking this medication and seek urgent medical attention
  • Swollen face, tongue or throat
  • Difficulty swallowing
  • Difficulty breathing
  • Wheezing or shortness of breath
  • Hives

Are you aware that:
  • You can visit Allergy UK or the NHS website to find out more about hay fever and allergic rhinitis?
  • You can irrigate your nasal passages with saline as non-medicated alternative. This can help wash allergens away from the sinus passages.
  • Avoiding allergens is the best way to reduce your risk of getting hay fever symptoms. Showering and washing hair after pollen exposure and keeping windows shut can help to reduce exposure to air-borne allergens and pollens.
  • Some medications (including 'non-drowsy' antihistamines such as fexofenadine) can still cause drowsiness in some individuals. It is your responsibility to ensure any medication you take does not adversely affect your ability to drive or operate machinery.
  • If there is no improvement or any worsening of symptoms you should seek further help/support from either Quick Meds or your GP.


GP Details

Would you like us to inform your GP of your treatment?
We recommend informing your GP surgery of any treatment that you are taking to keep your medical records relevant and up to date



Do you agree to the following?
  • You have answered all of the above questions accurately and truthfully. You understand our prescriber(s) will prescribe medication based on your responses and interactions with Quick Meds. Any incorrect responses or deliberate acts to misinform may be hazardous to your health.
  • You agree to the terms and conditions, privacy policy and terms of use.
  • You will familiarise yourself with the patient information leaflet included with your order and any other information relayed to you via other means including IM/E-mail/telephone.
  • You will contact us and inform your GP if you experience any side effects to treatment, if there are any changes to your medical history including starting any new medications or new diagnoses, or if your symptoms/medical conditions change in any way.
  • You understand completing a purchase does not guarantee supply of treatment; the final decision to prescribe lies with the prescriber with your best interests, health and appropriateness in mind.
  • You agree to the terms and conditions, privacy policy and terms of use.