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Online Appointments
- - Online Appointments - Coming Soon!
  GPs
- Psychologists
- - Frequently Asked Questions
    View all
  FAQ
- - Why choose Simple Online Doctor
    
    Our AHPRA registered health professionals are online and ready to help
    
    Australian Registered
    
    Convenient
    
    Easy to use
  Why Us
- - How it Works
    
    Make Appointment
    
    Make an appointment with one of our health experts for an online video consultation
    
    Information
    
    Complete a form to give us some information about why you want to chat to a doctor, and complete payment for your appointment
    
    Get Online
    
    Just be online at the correct time, and start your online consultation with one of our GPs
    
    Find Out More
  How It Works
Online Scripts
Medications
FAQs

Assessment Progress

1Your Condition
2Your health
3Your consent

Assessment

Ordered Before? Log in now, and save time completing your assessment and confirm you have verified your ID.

Item added to bag. Click here to view bag.

Please select a size from above to proceed.

There are NHS prescriptions in your basket. Please complete the order first or remove NHS prescriptions from the basket.

Patient Notice! This questionnaire forms the basis of your acid reflux consultation today. We need you to be honest with your answers including any current medication you are on. This allows our doctors to prescribe medication that helps you and offer accurate advice. We expect you to read the medicinal information provided before selecting your treatment.

1Your Condition

I understand Zantac and Losec are prescribed for occasional use only? *

No Yes

Important! If you require more than six Zantac 150mg tablets or four Losec 10mg capsules on a regular weekly basis, we advise you should see your regular GP. Change your answer yes to continue

I understand if all acid symptoms do not settle within 5 days of treatment I need to see my regular GP? Ranitidine 150mg one tablet twice daily or Omeprazole 20mg daily for 5 days should settle all symptoms for at least a few days. *

No Yes

Zantac 150mg one tablet twice daily or Losec 20mg daily ( or 2x10mg tablets) for 5 days should settle all symptoms for at least a few days. If not, you need to see your regular GP for a review and treatment.

I understand I require a review by my regular GP if the following apply:
Symptoms are not controlled by taking treatment two to three times weekly
Symptoms are changing or worsening *

No Yes

The following must apply to continue

Do any of the following apply to you?

Jaundice

Anaemia

Unintentional weight loss

Difficulty or pain on swallowing

Previous gastric ulcer or surgery

Vomiting, particularly if there is blood in the vomit

Age 45 or over with new onset of symptoms

Age 45 or over where symptoms are worsening

*

No Yes

You should not self-diagnose and arrange a face to face consultation with your regular GP. The following must not apply to you to continue.

2Your health

Are you currently taking any prescription-only medicines, alternative medicines or recreational drugs? *

No Yes

Please give more details

Do you have any known allergies to any medicine or substances? *

No Yes

Please give more details

Do you have any other health problems or conditions that you think we should know about? (e.g. Myasthenia Gravis, any enzyme deficiencies or recent major operations etc.) *

No Yes

Please give more details *

Are you pregnant or planning to become pregnant or breastfeeding? *

No Yes

Please give more details *

3Your consent

I confirm I am over 18 years old.

The medicine ordered is for my sole use only.

I will read the patient information leaflet supplied with the medicine specifically the side effects and dosages.

I take responsibility to inform my own regular doctor of the online consultation or any changes in my circumstances.

I agree to the Simple Online Doctor terms and conditions.

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