Herpes

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What state do you live in?
First, we need to make sure we are licensed in your state.
What state do you live in?*
Unfortunately we cannot service this condition in your state. Please contact your local physician for assistance.
Your state may require a phone or video consultation to complete your treatment. Don't worry! Your doctor will reach out to you if this is the case.

What is your first and last name?
Name*

First NameLast Name

What is your email?
What is your email?*
example@example.com
Type a question*

By Checking Here… You agree to receive doctor correspondence，transactional and/or marketing messaging from MetaHealthRX，to the email address that you provided above.

What is your phone number?
Please enter the best phone number to reach you on just in case the doctor has any questions regarding your medical information.
Phone Number*
Please enter a valid phone number.
Type a question*

By checking this box, I also consent by electronic signature to receive phone calls and/or SMS text messages at the phone number(s) below, including my wireless number if provided. I understand these calls may be generated using an automated technology, pre-recorded voices and that data rates may apply. I understand that my consent is not required to buy goods/services and I may opt out at any time to avoid receiving calls or SMS text messages.
domain*

What is your date of birth?
Birth Date*

MonthDayYear
You must be 18 to order this prescription medication.
today*

MonthDayYear
Date
age*

What is your gender?
What is your gender?*

MaleFemale

Are you currently taking any prescription or over-the-counter medications / vitamins / minerals / supplements?
Are you currently taking any prescription or over-the-counter medications / vitamins / minerals / supplements?*

YesNo
anyOtherMeds-IMP
Please list all prescription medications you are taking or are currently prescribed. Include all over the counter medications, vitamins, minerals, or supplements.
Please list all prescription medications you are taking or are currently prescribed. Include all over the counter medications, vitamins, minerals, or supplements.*
Many medications interact with Herpes medications. Your doctor wants to be sure of every medication you take. Are you SURE you do not take any other medications?
Yes: I affirm, I do NOT take any other medications.*

Yes: I affirm, I do NOT take any other medications.

Please select a reason for today's visit.
Please select all options that apply to you.
Please select a reason for today's visit.*

Refill medication to treat a future outbreakHave symptoms and want to get evaluated for a possible treatment plan.
Disclaimer: If you have not been formally diagnosed, we will require you to provide a photo of the affected area.Have not been formally diagnosed and not currently experiencing symptoms, but would like a new treatment plan
Please provide a photo of your latest prescription*
Please provide a photo of the affected area*
todaysVisit-IMP

We are sorry we cannot help you. This treatment plan does not apply to you.

Have you ever been diagnosed with oral herpes?
Have you ever been diagnosed with oral herpes?*

YesNo
When did you get diagnosed?
When did you get diagnosed?*

Does any of the following apply to you?
Does any of the following apply to you?*

I am pregnantI am breastfeedingI am planning on getting pregnantNone

Where do you experience cold sores or herpes simplex virus symptoms?
Please select all options that apply to you.
Where do you experience cold sores or herpes simplex virus symptoms?*

EyesGenitalsMouth or lipsOther
whereExpSym-IMP
Where are you experiencing symptoms?
Where are you experiencing symptoms?*

We are sorry we cannot help you. This treatment plan does not apply to you.

What is the frequency of outbreaks per year?
What is the frequency of outbreaks per year?*

Less than 1010 or more
fregOutbreaks-IMP

What symptoms do you experience along with your outbreaks?
Please select all options that apply to you.
What symptoms do you experience along with your outbreaks?*

Cracked lip cornersInternal mouth sores or ulcersItchingPain/Burning sensationLip blistersScabs or crustingOtherNone
Please describe other symptoms you are experiencing.
Please describe other symptoms you are experiencing*
whatSymAlongOutbreaks-IMP
otherSymptomsList-IMP
none_1
Please uncheck 'None' if you have selected any other options.

Do you experience any of the following symptoms?
Please select all options that apply to you.
Do you experience any of the following symptoms?*

Itchiness, burning, and tingling prior to the sore appearingPain in the neckChanges in vision (e.g., blurry vision, eye pain, eye irritation, tearing)Recurrent eye infectionsSensitivity to light and/or soundStrong headaches or nauseaFever more than 100.4NoneOther
Please provide details:
Please provide details*
doYouExpAnyFollwSym-IMP
none_2
Please uncheck 'None' if you have selected any other options.

We are sorry we cannot help you. This treatment plan does not apply to you.

We are sorry we cannot help you. This treatment plan does not apply to you.

Have you previously used any treatments for your cold sores herpes simplex virus symptoms?
Have you previously used any treatments for your cold sores herpes simplex virus symptoms?*

YesNo
Which treatments have you used? Please share if the treatment was effective and/or if you experienced any side effects.
Which treatments have you used? Please share if the treatment was effective and/or if you experienced any side effects.*
yesUsedTreatments-IMP
treatmentsUsedList-IMP

Do you have any known medical conditions?
Do you have any known medical conditions?*

YesNo
Please provide more details about your medical conditions.
Please provide more details about your medical conditions.*
hasKnownMedCond-IMP
detailsAbMedConditions-IMP

Do you have known allergies or intolerances to food, medications, dyes, or anything else?
Do you have known allergies or intolerances to food, medications, dyes, or anything else?*

YesNo
Please provide all known allergies and intolerances.
Please provide all known allergies and intolerances.*
allergiesOrIntolerances-IMP

Do you prefer an oral or topical medication? Please provide more details about your preference.
Do you prefer an oral or topical medication? Please provide more details about your preference.*

Oral (example: valacyclovir)Topical (example: zostrix)No preference
preferOralOrTopical-IMP
none_4

How long ago was your most recent check up with a physician?
How long ago was your most recent check up with a physician?*

Within past yearWithin 2 yearsWithin 3-5 yearsOver 5 years ago

Did you understand all the questions which were asked?
Did you understand all the questions which were asked?*

YesNo
Which question did you not understand?
Which question did you not understand?*
whichQuestion-IMP

Here's your first message to your doctor.
Please introduce yourself and feel free to:
- Ask any questions you have
- List any medical problem you have which were not discussed above
- Include anything else you would like the doctor to know.
Here's your first message to your doctor.*

0/0
moreToTellDoctor-IMP

Please acknowledge that you understand and agree to the following:

I have filled out a medical intake form that will be used by a board certified physician that is licensed in my state to make a medical treatment plan for me. I understand all the questions that have been asked of me. The information that I have provided is accurate and complete. I am the patient who is consenting to be evaluated for treatment.
Please acknowledge that you understand and agree to the following:*

I acknowledge and agree to the above.

Medication we offer:
Valacyclovir*

Outbreaks: Valacyclovir (Valtrex) 500mg
Quantity of 36 (enough for 6 outbreaks), billed and shipped quarterly (every 3 months)for $60.

Suppresive Therapy: Valacyclovir (Valtrex) 1 gram
Quantity of 90, billed and shipped quarterly (every 3 months)for $90.

Low-Dose Suppressive Therapy: Valacyclovir (Valtrex) 500mg
Quantity of 90, billed and shipped quarterly (every 3 months) for $75.
productRequested*
sku*
Should be Empty:

What state do you live in?

What is your first and last name?

What is your email?

What is your phone number?

What is your date of birth?

What is your gender?

Are you currently taking any prescription or over-the-counter medications / vitamins / minerals / supplements?

Please select a reason for today's visit.

We are sorry we cannot help you. This treatment plan does not apply to you.

Have you ever been diagnosed with oral herpes?

Does any of the following apply to you?

Where do you experience cold sores or herpes simplex virus symptoms?

We are sorry we cannot help you. This treatment plan does not apply to you.

What is the frequency of outbreaks per year?

What symptoms do you experience along with your outbreaks?

Do you experience any of the following symptoms?

We are sorry we cannot help you. This treatment plan does not apply to you.

Do you have any of the following conditions which may cause a weakened immune system?

We are sorry we cannot help you. This treatment plan does not apply to you.

Have you previously used any treatments for your cold sores herpes simplex virus symptoms?

Do you have any known medical conditions?

Do you have known allergies or intolerances to food, medications, dyes, or anything else?

Do you prefer an oral or topical medication? Please provide more details about your preference.

How long ago was your most recent check up with a physician?

Did you understand all the questions which were asked?

Here's your first message to your doctor.

Medication we offer: