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Medical and Smoking History Questionnaire

We’re going to ask you some brief questions about your health and smoking history in order to assess if a prescription is appropriate for you. We’ll also need to confirm that you’re over the age of 18.

We will pass your case to a registered doctor and he/she will then review your case and provide a prescription and treatment plan if appropriate.

If we’re unable to help, we’ll refund your fee in full.

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