Thrush Symptom Checker/Prescription

Have you tried the pharmacy first service at your local pharmacy?

They provide an excellent service and can issue you with antibiotics for your symptoms. It is often much faster to use this service.

The pharmacist will ask you about your symptoms in order to give the right advice.

If you are experiencing any of the following symptoms you should speak to your local community pharmacy team before contacting your GP.

unusual, white, thick vaginal discharge (often like cottage cheese)
itching and irritation or fissure (like paper cuts) around the vagina
pain when peeing or having sex

Please complete the form below if you think you may have thrush that cannot be treated through pharmacy first.

PLEASE BE AWARE

These requests are only processed between 8am and 3pm each day, any requests for treatment received after this time will be processed the next working day.

First Name

Surname

Date of birth

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Email *

Enter Email

Have you read and understood the information above regarding symptoms of thrush and pharmacy treatments available.

Yes

Have you ever had thrush before?

Yes

Are your symptoms the same as before?

Yes

Please check the symptoms that apply to you.

unusual, white, thick vaginal discharge (often like cottage cheese)

itching and irritation or fissure (like paper cuts) around the vagina

pain when peeing or having sex

Please check all that apply.

What treatment have you had in the past if any?

Vaginal Treatment

Tablets

Are you pregnant?

Yes

How would you like to collect your prescription?

Collection from Reception

Collect from your preferred Pharmacy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

I understand the practice will be in touch by close of business today either by text or call to offer the appropriate treatment, if form has been received by 3pm.