Name: Daphne
SKU: 94063
Price: 167.00 PHP
Availability: InStock

Biological Sex (required)

Female

Male

Other

If other, please specify:

How old are you?

Do you smoke?*

Do you/have you experienced migraines with aura? An aura is a change in vision that typically occurs before the start of some migraine headaches. They are often described as flashing or shimmering lights, zigzagging lines, or stars or blind spots in your field of vision.*

What was your blood pressure at your most recent reading within the last 6 months?

Are you fully breastfeeding or mix feeding?

Fully breastfeeding

Mix feeding

When was the first day of your last menstrual period?

Did you have any of the following medical conditions while pregnant?

Diabetes

Hypertension

Other

If you selected other, what condition was it?

To eliminate the possibility of pregnancy, please select the following that apply to you:

Your last monthly bleeding started within the past 7 days.

You abstained from sexual intercourse since your last monthly bleeding, delivery, abortion, or miscarriage.

You have been using a reliable contraceptive method consistently and correctly since your last monthly bleeding, delivery, abortion, or miscarriage.

You have had a baby in the last 4 weeks.

You had a baby less than 6 months ago and you are following the lactational amenorrhea method (LAM) of birth control (fully breastfeeding both day and night with no feeding intervals greater than 4 hours), and have had no monthly bleeding since then.

You have had a miscarriage or abortion in the past 7 days.

None of the above (IMPORTANT: If this is your answer, your order will only be approved if you also purchase a pregnancy test from the shop. Please take it to rule out pregnancy, before starting Daphne).

Please select the following situations that apply to you. If you are taking any of the medication below, our doctors will NOT be able to provide you with a prescription.

You are taking St. John’s Wort or oral fungal treatment

You are taking anticonvulsants or medications for nerve pain or bipolar disorder, containing carbamazepine, phenytoin, primidone, topiramate, oxcarbazepine, or lamotrigine

You are taking antibiotics containing Rifampin or Rifabutin

You are taking Barbiturates

You are taking Fosamprenavir

Please select the following menstrual issues that apply to you. If these apply, our doctors will NOT be able to provide you with a prescription and we recommend seeing a physician. You can book a phone consultation with an OB on our shop page.

Abnormal vaginal bleeding different from your usual period

Periods have become more frequent or heavier than your usual period

Abnormal bleeding between your periods

Select the situations and conditions that apply to you. If any of the following apply, our doctor will NOT be able to give you a prescription. In these cases, we recommend seeing a physician. You can book a phone consultation with an OB on our shop page.

You are over 40 years old and have NOT had a breast exam performed by a clinician in the last two years

You are over 40 years old and have NOT had a mammogram in the last two years

If you have any medical conditions not listed in the previous questions, please list them below.

Daphne

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If you have an existing prescription, upload it here!
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