Direct Medicines

Answer a few quick and easy questions from our pharmacists to see what treatments you’re eligible for

About You

Are you aged between 18 and 65?

Yes No

This question is required.

Do you know how and when to use your inhaler?

Yes No

This question is required.

Medication

Are you currently taking any of the following medications (including over the counter, prescription or recreational drugs)?

medicines for an irregular or fast heartbeat medicines for your asthma (apart from your existing inhaler ) such as oral asthma tablets xanthine derivatives (such as theophylline) or steroids to treat asthma water tablets (diuretics), sometimes used to treat high blood pressure or a heart condition

Yes No

This question is required.

Agreement

Do you understand that you must seek medical attention if your asthma does not improve within 1 hour of using your inhaler?

Yes No

This question is required.

Do you agree to the following?

You will read the patient information leaflet supplied with your medication You will contact us and inform your GP of your medication if you experience any side effects of treatment, if you start new medication or if your medical conditions change during treatment. The treatment is solely for your own use You have answered all the above questions accurately and truthfully. You understand our prescribers take your answers in good faith and base their prescribing decisions accordingly, and that incorrect information can be hazardous to your health.

Yes No

This question is required.

Health

Has your Asthma been reviewed by a doctor or nurse within the last 12 months?

Yes No

This question is required.

Have you been prescribed Ventolin (salbutamol) in the last 12 months?

Yes No

This question is required.

Is your asthma well controlled?

Yes No

This question is required.

Do you have an allergy (hypersensitivity) to Ventolin (salbutamol) or have you had a reaction with an asthma inhaler previously?

Yes No

This question is required.

Are you breast feeding or pregnant or planning to become pregnant in the next 6 months?

Yes No

This question is required.

Have you been diagnosed with any of the following?

Overactive thyroid gland History of heart problems such as an irregular or fast heartbeat or angina High blood pressure Any serious medical condition which may require immediate hospitalisation

Yes No

This question is required.

Symptoms

Have you called an ambulance or had emergency treatment for breathing problems in the last year?

Yes No

This question is required.

Do you use your inhaler more than four times a day?

Yes No

This question is required.

Have you been diagnosed with asthma by your doctor or nurse?

Yes No

This question is required.

I agree to the Terms and Conditions and I confirm that I am over 18.

Complete our 2 minute consultation

We’re almost done! M.Asad Sharif To make sure this treatment is safe for you to take, we just need you to answer a few questions.

M. Junaid Nadeem

Head of Pharmacy

Confidential & Secure

Our prescribers will review your details in complete confidence

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Need help?

If you need help with this medical assessment, contact our helpline:
0161 706 1964
or use our contact form.

Answer a few quick and easy questions from our pharmacists to see what treatments you’re eligible for

Are you aged between 18 and 65?

Do you know how and when to use your inhaler?

Are you currently taking any of the following medications (including over the counter, prescription or recreational drugs)?

Do you understand that you must seek medical attention if your asthma does not improve within 1 hour of using your inhaler?

Do you agree to the following?

Has your Asthma been reviewed by a doctor or nurse within the last 12 months?

Have you been prescribed Ventolin (salbutamol) in the last 12 months?

Is your asthma well controlled?

Do you have an allergy (hypersensitivity) to Ventolin (salbutamol) or have you had a reaction with an asthma inhaler previously?

Are you breast feeding or pregnant or planning to become pregnant in the next 6 months?

Have you been diagnosed with any of the following?

Have you called an ambulance or had emergency treatment for breathing problems in the last year?

Do you use your inhaler more than four times a day?

Have you been diagnosed with asthma by your doctor or nurse?

Confidential & Secure

Need help?

Have a question?

Visit our help centre

Email customer care

Call 01617061964

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Answer a few quick and easy questions from our pharmacists to see what treatments you’re eligible for

Are you aged between 18 and 65?

Do you know how and when to use your inhaler?

Are you currently taking any of the following medications (including over the counter, prescription or recreational drugs)?

Do you understand that you must seek medical attention if your asthma does not improve within 1 hour of using your inhaler?

Do you agree to the following?

Has your Asthma been reviewed by a doctor or nurse within the last 12 months?

Have you been prescribed Ventolin (salbutamol) in the last 12 months?

Is your asthma well controlled?

Do you have an allergy (hypersensitivity) to Ventolin (salbutamol) or have you had a reaction with an asthma inhaler previously?

Are you breast feeding or pregnant or planning to become pregnant in the next 6 months?

Have you been diagnosed with any of the following?

Have you called an ambulance or had emergency treatment for breathing problems in the last year?

Do you use your inhaler more than four times a day?

Have you been diagnosed with asthma by your doctor or nurse?

Confidential & Secure

Need help?