Opening mid-June at Westfield London. Register your interest to be first to know. Email us

Pre-consultation form

PrEP & PEP

A few confidential questions about your sexual health and risk factors. No judgement, no assumptions - just the information your doctor needs to prescribe safely and make the most of your consultation. Takes about 4 minutes.

~10 minutes 9 short sections Confidential
Just getting started 0 of 9 sections
These symptoms can indicate recent HIV infection - testing is recommended
HBsAg status is critical - tenofovir provides protection against hepatitis B. Stopping PrEP if HBsAg positive can cause serious flare.
e.g. osteoporosis, previous fractures. Long-term tenofovir may affect bone density.
Tenofovir safety data in pregnancy is limited

Here's what you've told us. Have a quick check, then hit send - this means your consultation can focus on what actually matters to you.

Your details

Name
Email
Phone
Date of birth

Service Required

What do you need? -

HIV & STI History

When was your last HIV test? -
Have you experienced any symptoms of acute HIV? -

Hepatitis Screening

What is your hepatitis B status? -
What is your hepatitis C status? -

Health Screening

Do you have any kidney problems? -
Do you have any bone health concerns? -
Do you have any liver problems? -
Do you have any other significant medical conditions? -
Are you currently pregnant or planning to become pregnant? -

Current Medications

Please list all current medications: -
Are you currently on PrEP? -

Mental Health & Support

Do you experience depression or anxiety? -
Do you have any concerns about substance use? -
Do you have concerns about disclosure (to partners, family, or workplace)? -
How would you rate your social support? -

Goals & Preferences

What are your main goals for this appointment? -
What type of consultation do you prefer? -
Is there anything else you'd like us to know? -
Your information is sent securely to your doctor at LoveMyLife. We will not share your details with third parties. By submitting this form, you consent to LoveMyLife contacting you regarding your appointment.