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Healthwoosh
VIAGRA ONLINE FORM
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Unsure
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Agree to Terms and Conditions
I understand that I should schedule a health check-up with my doctor as soon as I can within 6 months first receiving Viagra Connect to check for underlying medical problems that can sometimes be associated with erectile dysfunction.
I confirm that the information I have given is correct to the best of my knowledge. I am aware that I will need to attend the pharmacy in person and to speak with the pharmacist before Viagra Connect will be supplied. Our Pharmacy will retain the data provided above for one week to enable your consultation. Anonymised data will be retained for up to two years.
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Terms & Conditions
Service Privacy Policy
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