Acid Reflux Treatment Questionnaires

Acid Reflux Consultation

Your details

Please provide us with accurate details as our prescriber might need to access your GP record and you are consented to access your Summary Care Record (SCR). This is necessary for the safe and best treatment of your conditions.

This service to supply acid reflux medication is ONLY for occasional use!

If you require treatment more than 4 times per week on a regular basis you should contact with your regular GP.

Our clinician will not issue acid reflux medications for patients aged 55 years or over.

Unable to proceed, please consult your GP.

 
 

Unable to proceed, please consult your GP.

 
 

Unable to proceed, please consult your GP.

 
 

Unable to proceed, please consult your GP.

 
 

Unable to proceed, please consult your GP.

 
 

Unable to proceed, please consult your GP.

 
 

Unable to proceed, please consult your GP.

 
 

Consent

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