Your 2 minute consultation

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You'll need

Before you get started, it's a good idea to make sure you have the following information to hand:

  • Weight and height
  • Photo of your face
  • Photo of your ID

About you

Our doctors need to learn a little bit about you to help understand your condition.

What's your biological sex?

  • Male
  • Female

Cellphone number (mandatory)

e.g.5556661234. Please do not add +1. Enter only 10 digits, no spaces. * By entering your number, you agree to receive mobile messages related to your order.

What state do you live in?

What's your date of birth?

What do you weigh?

Use kg

How tall are you?

Use cm

Your health

We need to see if your medical history could affect the treatment options.

Do you smoke?

On average, how many units of alcohol do you drink in a week?

If you're not sure, you can calculate the number of units using our guide here: How many units of alcohol do I drink?

Do you regularly drink coffee?

Do you have any known allergies to any medications or substances?

Are you pregnant or planning to become pregnant?

Are you currently breastfeeding?

Do you have any of the following conditions:

Erosive esophagitis

Barrett's esophagitis

Esophageal ulcer / ulcerations

Heart disease

Diabetes mellitus

High cholesterol

High blood pressure

None of the mentioned diseases

Has anyone in your family had a gastrointestinal problem?

Have you had an unintended weight loss?

Do you have any other health problems or conditions that you think we should know about?

Acid Reflux

These questions let our doctor know how Acid Reflux affects you

Which of the following symptoms of acid reflux do you experience:

Sour belching

Burning in the chest area

Acid reflux

Other / no symptoms

When do these symptoms occur?

While lying down

After meals

At night

Other / no symptoms

How often do you have these symptoms?

Do you have any of these additional symptoms:

Difficulties swallowing

Coughing up blood

Blood in the stool

Black stool

Anemia

Weight loss

Recurrent vomiting

No additional symptoms

Do you take any medications for the symptoms listed above?

Have you had a gastroscopy (endoscopic camera inserted down your throat and into your stomach)?

Have you had a colonoscopy (endoscopic camera inserted via the anus to look at the bowels)?

Have you had a pressure measurement of the esophagus?

Have you had an acid measurement of the esophagus?

Have you been tested for blood in your stool?

Did you have a test for a bacterial infection (H. pylori)?

Have you ever received treatment for acid reflux before?

Is there any other information you would like to share with us, to help our doctors make an informed and a fair decision?

Your consent

We need to make sure that you are aware of and agree to some criteria before you choose your medicine.

Please tick to confirm you agree to the following:

I understand if all acid symptoms do not settle within 5 days of treatment I need to see my regular doctor


I agree to the terms and conditions

  • I confirm I am 18 years old or above
  • I am using this service on my own behalf and of my own free will and any treatment or advice is for my sole use only
  • I understand my consultation will not be passed to the Medzino clinical team until I have successfully completed payment
  • I will read the patient information leaflet supplied with the medicine or obtain it from the Mezino website; especially the side effects and dosages.
  • I take responsibility to inform my own regular doctor of the online consultation or any changes in my circumstances.
  • I agree to the Medzino terms and conditions.
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