Use this form to request treatment for a sexually transmitted infection.
Please complete all sections carefully and upload your test result.
Treatment can be offered for the following infections: Chlamydia, Mycoplasma, Trichomonas, Gardnerella, Ureaplasma, & Herpes simplex. Treatment for gonorrhoea requires an injection and cannot be given through this online facility.
If you are not already a Dokta patient, your request will not be valid until you complete the Dokta consent form.
This form is not for emergencies. If you have severe pain, fever, pelvic pain, testicular pain, rapidly worsening symptoms, or feel very unwell, seek urgent medical advice.
These should be the same as on your driving license or passport.
Allowed file types up to 2MB size:
A prescription code or token is a sequence of letters and numbers that you will receive by text message and email.
You can show that code to a pharmacy, tell them your date of birth and they will dispense your prescription. The cost is usually £10-15 for most treatments.
