What is the sex of the person(s) using this medication?

Is the medicine just for you?

What is the age, in years, of the intended user(s) of this product? Please give in months if younger than 1 year.

What symptoms will the product be used to treat?

How long have the symptoms been present?

Please provide any additional information that the pharmacist may need to know.

Have you had thrush more than twice in the last six months?

Is the intended customer(s) taking any other medication, including vitamins and herbal remedies?

Does the intended customer(s) live with any other medical conditions (e.g. diabetes, asthma)?

What is the sex of the person(s) using this medication?

Is the medicine just for you?

What is the age, in years, of the intended user(s) of this product? Please give in months if younger than 1 year.

What symptoms will the product be used to treat?

How long have the symptoms been present?

Please provide any additional information that the pharmacist may need to know.

Have you had thrush more than twice in the last six months?

Is the intended customer(s) taking any other medication, including vitamins and herbal remedies?

Does the intended customer(s) live with any other medical conditions (e.g. diabetes, asthma)?