Do you currently have or have ever had any of the following:

• A history of depression or any other mental health conditions?
• Current or previous diagnoses of prostate or male breast cancer?
• History of sensitivity (allergy) to finasteride (Propecia)?
• History of any inflammation on the scalp?

DISCLAIMER Please consent to the following:

• I have answered all the above questions in full accurately and truthfully and I will contact E Shop Pharmacy if there is any change to the above questions. I understand any incorrect information maybe detrimental to my health
• I am requesting treatment for myself and any prescribed treatment will be for my sole use
• The information provided will be collected and processed in accordance with GDPR regulations. I agree for my information to be processed by the E Shop Pharmacy in order to provide any treatment and that the prescribers will ultimately have the final decision whether to prescribe any medication
• If I suffer any side effects from my treatment I will contact E Shop Pharmacy and or my GP immediately
• I will read the patient information leaflet before taking the medication and I will contact a health care professional if I have any questions relating to my treatment or the information contained within it
• I should inform my GP that I am taking this medication
• I understand if I ever have a PSA test, which is a test for Prostate cancer, I must inform the person conducting the test I am taking Finasteride as it can affect the results of the test
• I understand it may take up to 6 months before I notice any reduction in hair loss and that should I stop taking Finasteride 1mg for whatever reason the effects may be reversed after 6 -12 months
• I understand women of child bearing age and pregnant women should NOT handle crushed or damaged Finasteride tablets
• I agree to the terms and conditions and privacy policy