Consultation Questionnaire | Tees Online Doctor

I confirm that I am aged 18 or over and that this consultation is for myself

I confirm that the information I have provided is accurate, complete, and truthful to the best of my knowledge.

I understand that providing incorrect or incomplete information may affect the safety and suitability of any advice or treatment given.

I understand that Tees Online Doctor is not an emergency service and that urgent or severe symptoms require immediate in-person medical care.

I understand that submitting this form does not guarantee treatment or a prescription, and that a clinician may decide that online care is not appropriate.

I will inform my GP and contact Tees online doctor if I experience any side effects from treatment, begin any new medication, or if my medical conditions change during the course of treatment

I consent to a qualified, UK-registered clinician reviewing my information and contacting me if further details are required.

I consent to Tees Online Doctor informing my GP about this consultation and any medication prescribed where necessary

I do not consent to my GP being informed at this time.

I consent to Tees Online Doctor accessing my NHS Summary Care Record (SCR) for the purpose of assessing my suitability for GLP-1 treatment and supporting safe prescribing. I understand that access to my SCR is limited to authorised healthcare professionals involved in my care and is recorded and audited.

I have read the Privacy Policy and Terms and Conditions and by submitting this consultation, I confirm my agreement to the above statements.