Q1: Are you male?

Q2: Are you under 18 years of age?

Q3: Do you suffer from hair loss that is symmetrical (the same on the rightas on the left side of your scalp) or are you diagnosed with male patternbaldness?

Q4: Have you used any medication for hair loss before?

Q5: Do you have any allergy to finasteride and/orPropecia or any of its ingredients?

Q6: Are you allergic to any medicines or other substances, for examplepeanuts or soya?

Q7: Is your hair loss in clumps or patches in arandom pattern?

Q8: Do you suffer from either sudden or rapid hairlos?

Q9: Is there any associated redness or inflammationto the scalp?

Q10: Is your hair loss limited to the temples or theside of the forehead?

Q11: Do you suffer from any illness or skin conditionthat may contribute to the hair loss?

Q12: Do you suffer from any of the following conditions?

a) Recent severe infections
b) Dietary conditions
c) History of cancer (e.g. prostate cancer)
d) Immune diseases
e) Endocrine disorders such as hyperprolactinaemia
f) Liver problems
g) Prostate problems
h) Problems urinating
i) History of depressive illness

Q13: Do you have any other health problems or conditions that you think we should know about?

Q14: Are you currently using finasteride for anyother indication?

Q17: Please confirm that you are aware of the following

a) Regrowth of hair can take up to 6 months after starting treatment and is most effective up to 2 years.
b) Women who are pregnant or likely to become pregnant should not handle finasteride tablets, especially if crushed or broken, because of the possibility of absorption of finasteride and the subsequent potential risk to a male fetus
c) You should use a condom when having sex if your partner is pregnant or could get pregnant as finasteride is released in semen
d) You must stop taking Finasteride immediately if you develop depression like symptoms and should seek medical attention promptly
e) Some users of Finasteride / propecia may experience depression or suicidal thoughts? Other people may experience decreased libido or sexual dysfunction. You should stop taking and seek medical attention promptly should you experience these side effects.

Q19: Consent

1) I confirm I am over 18 years old.
2) Any medicine ordered is for my sole use only.
3) I will read the patient information leaflet (PIL) supplied with the medicine specifically the side effects and dosages.
4) I take responsibility to inform my own regular doctor/GP of the online consultation or any changes in my circumstances.
5) I have answered all the above questions accurately and truthfully and I am aware that incorrect information can be hazardous to my health
6) I agree to the excelsior terms and conditions.

I agree to the Terms and Conditions and I confirm that I am over 18. You must agree to continue.

Important: Consultation Required Before Order Fulfilment Please note that your order will only be fulfilled after a consultation with our prescriber. Once your order is placed, we will send you a link to book an appointment with the prescriber. Please complete the consultation to confirm your eligibility for the treatment.