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Male Patients Form 2

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Premature Ejaculation

Your Details

First Name *

Last Name *

Email *

Mobile *

Date of birth *

Sex *

Male

Female

Home Address *

County *

Country *

EirCode *

Pharmacy Name *

Pharmacy Location *

Pharmacy EirCode *

Medical Questions

Do you have any significant current or past medical conditions? *

Yes

Are you currently taking any medication? Please advise which ones. *

Yes

Are you allergic to any Medications? *

Yes

Are you currently breastfeeding *

Yes

Package Plans:

Standard: within 24 hours 24.99 EUR

*Applications will be reviewed and if approved, a certificate signed by an Irish doctor will be sent via email within 24 hours.

RECOMMENDED: within 12 hours 29.99 EUR

*Applications will be reviewed and if approved, a certificate signed by an Irish doctor will be sent via email within 12 hours.

GET HEALTHCARE ONLINE LIMITED.

Get Healthcare is a one-stop telehealth platform based in Ireland. We offer only online medical services to make it easy for busy working professionals and university students to catch up with their minor healthcare needs in a seamless and hassle-free manner.

Address: Ludgate Hub, Old Bakery, Townshend Street,
Skibbereen, Co. Cork, P81T324, Ireland

Support phone number: 0212455185

Male Patients Form 2

Premature Ejaculation

Your Details

Medical Questions

Medical Questions

Package Plans:

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