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Answer a few questions so we can help

In which state do you currently reside?

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We regret to inform you that we do not currently offer shipping to your state of residence. We are not available in the following states: AL, AK, AR, CA, CO, DE, HI, ME, OK, SC, SD, WV, WY. We apologize for any inconvenience and appreciate your understanding.

What is your Date of Birth?

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Thank you for visiting UBI Telehealth. Our products are intended only for those who are 18 years of age or older, in accordance with legal and medical guidelines. Please consult with your primary care provider for a personalized treatment plan that is both safe and effective for you. We invite you to browse our other available products, as there may be an alternative that better suits your needs.

What was your sex assigned at birth?

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Thank you for visiting UBI Telehealth. This workflow pertains to male erectile dysfunction. Please refer back to product list for women.

Are you currently pregnant or breastfeeding?

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Thank you for visiting UBI Telehealth. This product shouldn't be used if you are currently pregnant or breastfeeding. Please consult with your primary care provider for a personalized treatment plan that is both safe and effective for you. We invite you to browse our other available products, as there may be an alternative that better suits your needs.

Patient Attestation

I hereby declare that I have read and understood the following terms and conditions related to obtaining an online prescription:

Telemedicine Consultation: I understand that the prescription will be provided to me based on an online consultation with a qualified healthcare professional. I acknowledge that this consultation may take place via video call, phone call, or secure messaging platform.

Accurate Information: I certify that all the information provided during the consultation, including my medical history, current medications, allergies, and other relevant details, is accurate and complete to the best of my knowledge.

Informed Consent: I acknowledge that the healthcare professional will rely on the information provided by me to make clinical decisions and prescribe medication. I understand the benefits, risks, and potential side effects of the prescribed medication and have had the opportunity to ask questions or seek clarification.

Prescription Validity: I acknowledge that the prescription provided to me is valid for the specified duration as determined by the prescribing healthcare professional. I understand the importance of regular follow-ups and will schedule appropriate appointments as recommended.

Responsible Use: I will use the prescribed medication solely for my personal use and in accordance with the healthcare professional's instructions. I will not share the medication with others or use it for any purposes other than its intended use.

Safety and Monitoring: I understand the importance of monitoring for any adverse reactions or unexpected changes in my health while taking the prescribed medication. I will promptly report any concerns or side effects to the healthcare professional.

Compliance with Regulations: I acknowledge that the online prescription process is subject to applicable local laws, regulations, and guidelines. I will comply with all legal requirements related to obtaining and using the prescription.

Disclaimer: I understand that the online prescription is based on the information provided during the consultation and does not replace an in-person examination by a healthcare professional. I agree to assume full responsibility for any consequences arising from the use of the prescribed medication.

I hereby declare that I have carefully read and understood the above terms and conditions. I agree to abide by them and acknowledge that any failure to comply may result in the invalidation of the prescription.

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Date: 09/19/2024

Are you currently pregnant or breastfeeding?

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Thank you for visiting UBI Telehealth. This product shouldn't be used if you are currently pregnant or breastfeeding. Please consult with your primary care provider for a personalized treatment plan that is both safe and effective for you. We invite you to browse our other available products, as there may be an alternative that better suits your needs.

Have you ever taken Minoxidil, Ketoconazole, Latanoprost, or Finasteride?

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Did you experience undesirable side effects or allergic reactions?

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Thank you for visiting UBI Telehealth.  You shouldn't use this particular product if you have experienced allergic reaction or side effects before. Please consult with your primary care provider for a personalized treatment plan that is both safe and effective for you. We invite you to browse our other available products, as there may be an alternative that better suits your needs.

Have you been diagnosed with any scalp condition such as psoriasis, eczema, or seborrheic dermatitis?

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Have you previously used any hair restoration treatments or products?

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Which ones and for how long?

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Have you ever been diagnosed with thyroid disorder?

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Have you ever had significant changes in weight recently?

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How much weight did you lose and in what time period?

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Does anyone in your immediate family have a history of significant hair loss or pattern baldness?

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What are your expectations regarding the effectiveness of the hair restoration product?

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