<p class="MsoNormal" style="margin: 0cm; font-size: medium; font-family: &quot;Times New Roman&quot;, serif; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0);"><span style="font-family: &quot;Apple Color Emoji&quot;;">☑️</span><span style="font-size: 13.5pt; font-family: Calibri, sans-serif;">&nbsp;I will read the Patient Information Leaflet provided with my medication before use.</span><span style="font-family: &quot;Source Sans Pro&quot;, sans-serif; color: rgb(33, 37, 41);"><br style="caret-color: rgb(33, 37, 41);"><br style="caret-color: rgb(33, 37, 41);"></span><o:p></o:p></p><p class="MsoNormal" style="margin: 0cm; font-size: medium; font-family: &quot;Times New Roman&quot;, serif; caret-color: rgb(0, 0, 0); color: rgb(0, 0, 0);"><u1:p></u1:p><span style="font-size: 13.5pt; font-family: &quot;Apple Color Emoji&quot;;">☑️</span><span style="font-size: 13.5pt; font-family: Calibri, sans-serif;">&nbsp;I will contact ifeelshy and inform my GP immediately if I experience any side effects, start a new medication, or if my medical conditions change during treatment.<o:p></o:p></span><u1:p></u1:p></p><p class="MsoNormal" style="margin: 0cm; font-size: medium; font-family: &quot;Times New Roman&quot;, serif; color: rgb(0, 0, 0); caret-color: rgb(0, 0, 0);"><span style="font-size: 13.5pt; font-family: &quot;Apple Color Emoji&quot;;">☑️</span><span style="font-size: 13.5pt; font-family: Calibri, sans-serif;">&nbsp;I understand that the treatment is for my personal use only and will not be shared with anyone else.<o:p></o:p></span><u1:p></u1:p></p><p class="MsoNormal" style="margin: 0cm; font-size: medium; font-family: &quot;Times New Roman&quot;, serif; color: rgb(0, 0, 0); caret-color: rgb(0, 0, 0);"><span style="font-size: 13.5pt; font-family: &quot;Apple Color Emoji&quot;;">☑️</span><span style="font-size: 13.5pt; font-family: Calibri, sans-serif;">&nbsp;I confirm that I have answered all questions accurately and truthfully to the best of my knowledge.<o:p></o:p></span><u1:p></u1:p></p><p class="MsoNormal" style="margin: 0cm; font-size: medium; font-family: &quot;Times New Roman&quot;, serif; color: rgb(0, 0, 0); caret-color: rgb(0, 0, 0);"><span style="font-size: 13.5pt; font-family: &quot;Apple Color Emoji&quot;;">☑️</span><span style="font-size: 13.5pt; font-family: Calibri, sans-serif;">&nbsp;I understand that the prescriber relies on my answers in good faith, and that providing incorrect or incomplete information could affect my health.<o:p></o:p></span><u1:p></u1:p></p><p class="MsoNormal" style="margin: 0cm; font-size: medium; font-family: &quot;Times New Roman&quot;, serif; color: rgb(0, 0, 0); caret-color: rgb(0, 0, 0);"><span style="font-size: 13.5pt; font-family: &quot;Apple Color Emoji&quot;;">☑️</span><span style="font-size: 13.5pt; font-family: Calibri, sans-serif;">&nbsp;I understand that while treatment decisions are made jointly between myself and the prescriber, the final decision to issue a prescription rests with the prescriber.<o:p></o:p></span><u1:p></u1:p></p>