Get a Prescription for Thrush

- Step 1 of 6

Name *

First

Last

Date of Birth *

Email *

Address *

Select Pharmacy to where prescriptions should be sent. Select "other" if you can't find your pharmacy *

1. Please share your birth gender? *

2. Are you pregnant? *

3. Are you breastfeeding? *

4. Do you have bleeding in between your periods or after sexual intercourse? *

5. Do you have any symptoms of thrush in other areas of your body? e.g. tongue *

6. Please share your age with us *

7. Are you experiencing pain when urinating or feel you are urinating more than normal? *

8. Do you have discharge? *