Blisters or crusting on the lips (fluid-filled)

Mouth ulcers or lumps lasting more than 3 weeks

Painful red or white patches inside the mouth

Difficulty swallowing or persistent throat discomfort

Fever, swollen glands, or feeling generally unwell

Severe pain or rapidly worsening symptoms

Unusual swelling around the lips, face, or gums

Electrolyte abnormalities - any imbalance in potassium, sodium, magnesium, or calcium that could affect the heart, nerves, or overall stability.

Immune system conditions (e.g., cancer, HIV, immunosuppressive disorders) - any illness or treatment that weakens your immune system, reducing your ability to fight infections.

Kidney problems - reduced kidney function, chronic kidney disease, or any condition that affects how your body clears medicines.

Liver problems - Liver damage or disease (e.g., hepatitis, fatty liver, cirrhosis) which may alter how medicines are processed.

Nervous system abnormalities - conditions affecting the brain or nerves, including seizures, neuropathy, multiple sclerosis, or other neurological disorders.

Serious medical conditions requiring immediate or urgent care - Any severe or unstable illness—such as major infections, recent hospitalisation, uncontrolled health conditions, or sudden deterioration.

☑️ I will read the Patient Information Leaflet provided with my medication before use.

☑️ 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.

☑️ I understand that the treatment is for my personal use only and will not be shared with anyone else.

☑️ I confirm that I have answered all questions accurately and truthfully to the best of my knowledge.

☑️ I understand that the prescriber relies on my answers in good faith, and that providing incorrect or incomplete information could affect my health.

☑️ 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.