Urinary Tract Infection Appointment
Dealing with symptoms of a urinary tract infection (UTI)? The Clinic at Gibbs Pharmacy offers quick, confidential evaluations and same-day treatment options—no lengthy wait times or doctor’s office visits required. Our pharmacists can assess your symptoms and, if appropriate, prescribe medication to help you feel better fast. Book your appointment today and get back to comfort and confidence with care you can trust.
Name
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First Name
Last Name
Date of Birth
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Month
-
Day
Year
Date
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Patient Sex
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Male
Female
Men with UTIs are at a greater risk of developing a kidney infection. We are not able to screen or treat kidney infections at The Clinic at Gibbs Pharmacy. At this time, we are only able to treat women for UTIs. We want the best care for our patients, and sometimes that requires patients to be seen elsewhere, such as their primary care office.
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I understand that I will not receive treatment for a UTI if tested at The Clinic at Gibbs Pharmacy.
Have you had a UTI in the past?
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Yes
No
At this time, we are not able to treat patients who have never been diagnosed with a UTI in the past, as these patients may require a different level of care. We want the best care for our patients, and sometimes that requires patients to be treated elsewhere, such as their primary care office or an urgent care.
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I understand that I will not receive treatment for a UTI if tested at The Clinic at Gibbs Pharmacy.
Do any of the following apply to you:
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Pregnant
Previous UTI within the past 2 weeks
History of childhood urinary tract infections
Urological abnormalities
History of diabetes
Immunocompromised
Postmenopausal
None of the above
We will not be able to treat you at The Clinic at Gibbs Pharmacy due to your selection, as you are at a higher risk of a serious UTI and/or kidney infection. We can perform testing, but we would not be able to prescribe you treatment. We want the best care for our patients, and sometimes that requires patients to be treated elsewhere, such as their primary care office.
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I understand that I will not receive treatment for a UTI if tested at The Clinic at Gibbs Pharmacy.
Do you have any of the following symptoms:
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Fever
Sweating
Flank pain from suspected UTI (pain on either side of your lower back, just above your hips)
Shaking
Chills
Nausea
Vomiting
Abnormal vaginal discharge
None of the above
We will not be able to treat you at The Clinic at Gibbs Pharmacy based on your previous selection, as these symptoms suggest you are at risk of developing a more serious infection. We can perform testing, but we would not be able to prescribe you treatment. We want the best care for our patients, and sometimes that means we recommend patients are seen elsewhere, such as their primary care office.
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I understand that I will not receive treatment for a UTI if tested at The Clinic at Gibbs Pharmacy.
Appointment
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