Your 2 minute consultation

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About you

Our doctors need to learn a little bit about you to help understand your condition.

What's your gender?

  • Male
  • Female

What's your date of birth?

What do you weigh?

How tall are you?

Your health

We need to check if anything in your medical history could affect your condition or treatment options.

Have you been diagnosed with a psychiatric disorder such as depression, anxiety or panic attacks?

Have you ever had seizures or been diagnosed with epilepsy?

Do you suffer from any problems with your kidneys or your liver?

Are you currently taking any prescription-only medicines, alternative medicines or recreational drugs?

Do you have any known allergies to any medicine or substances?

Are you pregnant or planning to become pregnant or breastfeeding?

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

Stop Smoking

These questions let our doctor know how stop smoking affects you.

How long have you been smoking?

How many cigarettes do you smoke a day?

Have you tried to quit smoking before?

Have you tried Champix (Varenicline) in the past to stop smoking?

Your consent

We need to check that you're aware, of and agree to a couple of things before choosing your medication.

We strongly advise that you inform your GP of any treatment you receive. Would you like us to do this on your behalf?

Please tick to confirm you agree to the following?

I understand that I should stop taking Champix if agitation, depressed mood or changes in behaviour are causing concern

I understand that people new to Champix need to order a 2 week starter pack first to build up dose

I agree to the terms and conditions

You confirm that you are over 18 years old. The treatment ordered is for your own use. You will read the patient information leaflet supplied with the medication. You will contact Dr Felix and inform your GP if you experience any side effects from the treatment prescribed to you or if there are any changes in your circumstances. You have answered all questions truthfully and accurately to allow our doctors to provide you with a safe service as inaccurate information can be hazardous to your health. You have read, understand and agree to abide by the Dr Felix  terms and conditions.


Don’t forget, only our qualified doctors see the answers you provide.