Flomax | Symptoms-Check Questionnaire

Welcome to the digital Flomax Relief Symptoms-check Questionnaire. This tool will help you and your pharmacist ascertain whether Flomax Relief is suitable for you.

Work through the questions, answering each question. You will need to take the results to discuss with your pharmacist, who will decide whether you can be sold Flomax Relief.

If you get green lights for all questions, your pharmacist may agree that Flomax Relief may be suitable for you.

If you get an amber light for any question, this indicates that Flomax Relief may not be suitable for you. The pharmacist will want to ask some more questions, to make sure.

If you get a red light for any question, Flomax Relief is not suitable for you and a visit to your GP is necessary. We recommend that you complete the questionnaire anyway, because the results can be printed and taken with you to your GP.

About you...

Yes

a	Are you under the age of 45 years? Flomax Relief can only be sold to men aged 45 to 75 years. You should make an appointment with your GP to discuss your symptoms. We recommend you complete the questionnaire. Alternatively, click here to finish now.
b	Are you over the age of 75 years? Flomax Relief can only be sold to men aged 45 to 75 years. You should make an appointment with your GP to discuss your symptoms. We recommend you complete the questionnaire. Alternatively, click here to finish now.
c	Have you had prostate surgery? Flomax Relief is only suitable for men who have not undergone prostate surgery. You should make an appointment with your GP to discuss your symptoms. We recommend you complete the questionnaire. Alternatively, click here to finish now.
d	Has your doctor ever diagnosed you as having diabetes? If your diabetes is stable (your blood sugars are well controlled), you may be given Flomax Relief, as long as all other criteria are met. If your diabetes is unstable (your blood sugars are not well controlled), you should make an appointment to see your GP. This is because the urinary symptoms you are experiencing may be due to diabetes, not BPH. Flomax Relief is not suitable for you. You should make an appointment with your GP to discuss symptoms. We recommend you complete the questionnaire. Alternatively, click here to finish now.
	Is your diabetes stable?

About your urinary symptoms…

Yes

a	Has your doctor already diagnosed you as having an enlarged prostate gland otherwise known as BPH (benign prostatic hyperplasia)?
	Are you currently taking any prescribed medicines for your BPH from your GP? Flomax Relief cannot be supplied to you yet. You should make an appointment to see your GP, who can decide whether you can be sold Flomax Relief or not. We recommend you complete the questionnaire. Alternatively, click here to finish now.
b	Have you had these urinary (peeing) symptoms for at least 3 months? It is important to establish how long you've been having these symptoms. Flomax Relief is not suitable for you. You should make an appointment with your GP to discuss your symptoms. We recommend you complete the questionnaire. Alternatively, click here to finish now.
	If you have had these uninary symptoms for less than 3 months, you must see your GP, to discount short-term or acute conditions e.g. Urinary tract Infection (UTI). If this is the case, tick here
	However, If you've had these symptoms for longer than 3 months, but they've only become bothersome recently, tick here.

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Symptoms-Check Questionnaire