Are you between the ages of 18 and 74? YesNo
Do you suffer from prediabetes, diabetes, heart disease, high blood pressure, high cholesterol or obstructive sleep apnoea? YesNo
Do you agree that you have answered all of the above questions accurately and truthfully. You understand our prescribers will prescribe medication based on your responses, any incorrect responses or deliberate acts to misinform may be hazardous to your health. You are happy for your consultation to be reviewed by a Pharmacist Independent prescriber.
I agree to ABC accessing my NHS Summary Care Record to confirm my identity and check my health record and subsequently inform my GP about the provided treatment
