Icon-facebook Linkedin Instagram
Search
Close this search box.
Icon-facebook Linkedin Instagram

Urinary Tract Infection Survey

Urinary Tract Infection

There are only a few steps to get started.

    Choose your Location

    What is your date of birth?

    What symptoms have you experienced?

    Tell us more

    How long have you had the previously listed symptoms?

    Have you had a urinary tract infection before?

    What other symptoms do you have?

    You may need to see a doctor face-to-face as soon as possible due to these other symptoms.

    Tell us more

    Do You have any of the following medical conditions?

    A UTI paired with certain medical conditions necessitates to see a doctor in person. Choose all that apply to you.

    Are you allergic to any medicine? (Include antibiotics)

    Please list your drug allergies and what happens when you use that drug.

    Do you take other medication(s) or have any other medical conditions?

    Please let us know what medications you are taking and what diseases you have so that we can provide you with the best treatment possible.

    Do you have any of these conditions?

    Please specify

    Anything else you would like us to know?

    Tell us about any concerns or questions you have for the medical team.

    How would you like to pay?

    upload emirates insurance details (if available) Upload a Photo of your Emirates ID Upload Front Upload Back

    Billing and delivery details

    Google Map: (Please Share your Google Map Link) Delivery Location Neighborhood/Area: Street Name/No: Address Details:

    Personal Details

    Title: First Name: Last Name: Mobile Number: E-mail:

    Confirm Request and Agree to Terms