Online Prescription Assessment

1. How long are you suffering from Premature Ejaculation?

2. What is your date of birth?

3. What is your biological sex?

We are sorry but this product can not be issued for the chosen gender.

4. Do you smoke or drink?

Drinking and smoking can reduce the effect of the medicine

5. Are you aware that this medication is a treatment for Premature Ejaculation and not for Erectile Dysfunction and that you cannot combine these drugs?

Please read the leaflet carefully before you are using this medication

6. Do you suffer from any liver, kidney or thyroid problems?

We are sorry, but we cannot issue the medication, please visit your local doctor

7. Do you suffer from any cardiovascular diseases and are you currently treating them?

8. When was the last time you checked your blood pressure?

Please check your blood pressure and give correct values before you purchase

9. Do you know what are the reasons that you suffer from Premature Ejaculation?

10. Do you experience Premature Ejaculation when you masturbate?

11. What was your last blood pressure?

This medicine is not recommended for you
This medicine may be unsuitable if you don’t take the regular hypertension medicine


13. When exactly does your ejaculation occur? (Please select all the descriptions that apply)

14. Do you want to provide any additional information to the doctor?

15. Do you agree not to combine erectile dysfunction drugs and premature ejaculation drugs at once

We are sorry, but we cannot issue the medication

16. Would you like us to inform your GP about this order?

17. Do you agree for the following:

We are sorry, but we cannot issue the medication