Pharmacy First - Sinusitis - The Family Chemist

1. Please provide the patient's details:

First Name *

Last Name *

Date of Birth *

Gender *

Email Address:

Postcode:

Phone Number:

Consent to Access Your Summary Care Records?

2. Please select which symptoms you're experiencing (select all that apply):

Blocked or runny nose

Headaches or pain/pressure around my forehead, eyes or cheeks

Reduced sense of smell

Coughing during the day or at night

None of the above

2b. You may not be experiencing signs of sinusitis, please contact your GP or a local pharmacy for review of your symptoms.

Thank you

We appreciate the time spent answering this questionnaire.

Your symptoms may need further investigation and we are unable to provide treatment through Pharmacy First, please visit your GP or contact NHS 111 for further advice and support.

3. Please select if any of the below symptoms apply:

I am pregnant (and under the age of 16)

I am currently on medication that dampens down my immune system

I have tried oral medication for this already but it hasn't helped

I have had these symptoms for more than 12 weeks (chronic sinusitis)

None of the above

3b. Your symptoms may need further investigation and we are unable to provide treatment through Pharmacy First, please visit your GP or contact NHS 111 for further advice and support.

Thank you

We appreciate the time spent answering this questionnaire.

Your symptoms may need further investigation and we are unable to provide treatment through Pharmacy First, please visit your GP or contact NHS 111 for further advice and support.

5. I can confirm that I have answered the questions to the best of my ability and I am experiencing the symptoms I have selected:

Yes

5b. Please select a suitable date and time to book your appointment for a video consultation on the next page. If you start feeling worse before the consultation, seek more urgent care.

We need to speak with you

We have gathered enough information

Please use the link below to go book an video call consultation about your conditions, please note we will be able to tell you more and answer any questions during the consultation.

Cancel

Name	Purpose	Expiry
CFID	This is a session cookie and is necessary for the operation of the site.	1 day
CFTOKEN	This is a session cookie and is necessary for the operation of the site.	1 day
SBCOOKIECONSENT	This cookie allows us to remember what choices you made relating to cookies you want to use on this site	1 year

Name	Purpose	Expiry
__UTMA	Used to distinguish users and sessions. The cookie is created when the javascript library executes and no existing __utma cookies exists. The cookie is updated every time data is sent to Google Analytics.	2 years from set
__UTMB	Used to determine new sessions/visits. The cookie is created when the javascript library executes and no existing __utmb cookies exists. The cookie is updated every time data is sent to Google Analytics.	30 mins from set
__UTMC	Set for interoperability with urchin.js. Historically, this cookie operated in conjunction with the __utmb cookie to determine whether the user was in a new session/visit.	When browser closed
__UTMT	Used to throttle request rate, used by Google Analytics	10 minutes
__UTMV	Used to store visitor-level custom variable data. This cookie is created when a developer uses the _setCustomVar method with a visitor level custom variable. This cookie was also used for the deprecated _setVar method. The cookie is updated every time data is sent to Google Analytics.	2 years from set
__UTMZ	Stores the traffic source or campaign that explains how the user reached your site. The cookie is created when the javascript library executes and is updated every time data is sent to Google Analytics.	6 months from set

Pharmacy First – Sinusitis

0115 850 1944

enquiries@thefamilychemist.co.uk

Unit 1, Wilford Business Park,
Ruddington Lane,
Nottingham,
NG11 7EP

Opening times

Today’s Responsible Pharmacist

Sign In