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Emergency Medication Evaluation

Duration: 5-7 Min. Call or text for help 1-888-503-1918

Please complete our brief health and lifestyle history questionnaire to receive emergency preparedness medications tailored for your safety and suitability. This complimentary evaluation is designed for quick completion, requiring just a few minutes of your time to ensure optimal care.

WELCOME

21+

Please confirm your age to continue

Must be at least 21 years of age

IMPORTANT

Drug Resistance: What It Is and How to Prevent It

Great work! Taking charge of your family's well-being and being responsible for your health, instead of relying on the system, is commendable. By understanding the impact of drug resistance, we can further empower ourselves and our communities to make informed decisions and prevent its spread. Let's explore this issue further.

Explanation: Drug resistance occurs when microorganisms, such as bacteria or viruses, develop the ability to survive and multiply despite exposure to drugs or medications meant to kill them. To avoid drug resistance, it's crucial to use antibiotics and antivirals responsibly, complete prescribed treatments as prescribed by your doctor.

Public education and healthcare stewardship play vital roles in preventing drug resistance.

ORDERING

*Each person must complete a purchase

DEPENDENT INFO

If ordering for multiple dependents, a separate form and transaction are needed for each. Return to the main page when complete to complete an additional form.

SUITABILITY

SECURE MESSAGING: USHWN Connect

If your doctor requires additional details for your prescription kit, we'll send you a secure USHWN Connect link via text or email for the doctor's chat, along with a 4-digit code for quick, private conversations. Typically, expect a response within an hour, or at most, within 24 hours on weekdays

I agree to terms & conditions provided by the company. By providing my phone number and email, I agree to receive text messages and emails from Rx.Life and affiliates needed to coordinate your care.

CONTACT INFO

Your name as it appears on your government issued ID

SHIPPING ELIGABILITY

Check shipping eligability

GENDER

MATERNITY

Are you breastfeeding?

ALLERGIES

Please indicate if you have allergies to any of the medications listed:

ALLERGIES

Write the name of the medication and type of reaction experienced. For example: I get hives when taking penicillin. I experience swelling and difficulty breathing when taking ciprofloxacin.

After completing the encounter a Rx.life physician may reach out to get more information and determine whether or not a prescription for an emergency supply of antibiotics is appropriate for you.

Indicate allergies to the medications listed previously

Indicate Allergies To The Medications Previously Listed

MEDICAL HISTORY

Do you have any chronic conditions?

MEDICAL HISTORY DETAILS

MEDICAL HISTORY

Have you or any of your family members been diagnosed with significant conditions such as cancer, heart disease, or genetic disorders?

FAMILY HEALTH HISTORY

For "Family Health History", if you selected "Yes", list any significant family illnesses that could affect your health.

CURRENT HEALTH STATUS

Are you experiencing any current symptoms or conditions that have not yet been mentioned?

CURRENT HEALTH STATUS

For "Current Symptoms and Conditions", if you selected "yes", please describe any health issue health issues or symptoms you're experiencing and when they started.

MEDICATION DETAILS

Do you take any prescription medications?

MEDICATION DETAILS

For "Prescription Medications", if you selected "Yes", provide the name of the prescription medication you are currently taking.

Check here if you would like to receive pricing for a year's supply of your maintenance medications

MEDICATION DETAILS

Do you take over-the-counter medications or supplements?

MEDICATION DETAILS

Over the counter medication details

MEDICATION DETAILS

Have you ever had an adverse reaction to antibiotics or any other medication?

MEDICATION DETAILS

Antibiotic adverse reaction

MEDICATION DETAILS

Do you have other conditions or other medications not mentioned previously?

LIST OTHER MEDICATION DETAILS

none if empty

RECENT TRAVEL

Have you traveled internationally in the past 14 days?

HIGH-RISK AREA FOR COVID-19

Have you had a possible COVID exposure?

SYMPTOMS

Have you experienced COVID-19 symptoms in the past 14 days?

COVID TESTED

Have you been tested for COVID-19 in the past 14 days?

If Yes , enter COVID Test Results

RESULTS

Based on your health profile, the following medications could be available for personalized emergency kit.

  1. Amoxicillin-Clavulanate 875/125 mg - 28 tablets

  2. Azithromycin 250 mg - 12 tablets

  3. Doxycycline Hyclate 100 mg - 60 capsules

  4. Fluconazole 150 mg - 2 tablets

  5. Metronidazole 500 mg - 30 tablets

  6. Ivermectin 18mg/36mg/54mg - 21 capsules

  7. Ondansetron 4 mg - 6 tablets

  8. Hydroxychloroquine 200 mg - 20 tablets

  9. Azithromycin 250 mg - 6 tablets (may be a different packaging size)

  10. Budesonide 0.5 mg - 10 vials

  11. OrthoMune OTC - 1 bottle

Next choose your kit