Bronchitis MIF – GoodpillRx

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Goodpillrx Pharmacy's Telehealth Dept Offers Prescriptions By U.S. Licensed Doctors

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Men
- SEX
- Low Testosterone
  - Lab Testing
- SKIN
- Hair
- Anti-Aging Kits
- Pain
- Weight Loss
- Anxiety
- Migraine
- Lab Test Kits
- More
Women
- Sex
- Hormones
- Women’s Fertility
- SKIN
- Thyroid
- Weight Loss
- Hair
- Migraine
- Lab Test Kits
- Pain
- Anxiety
Pets
- Dogs
- Cats
- Horses
Lab Testing
Active Aging
Treatments
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Latest Medications

Men
- SEX
- Low Testosterone
  - Lab Testing
- SKIN
- Hair
- Anti-Aging Kits
- Pain
- Weight Loss
- Anxiety
- Migraine
- Lab Test Kits
- More
Women
- Sex
- Hormones
- Women’s Fertility
- SKIN
- Thyroid
- Weight Loss
- Hair
- Migraine
- Lab Test Kits
- Pain
- Anxiety
Pets
- Dogs
- Cats
- Horses
Lab Testing
Active Aging
Treatments
Therapies
Covid-19
Latest Medications

Goodpillrx Pharmacy's Telehealth Dept Offers Prescriptions By U.S. Licensed Doctors

Men
- SEX
- Low Testosterone
  - Lab Testing
- SKIN
- Hair
- Anti-Aging Kits
- Pain
- Weight Loss
- Anxiety
- Migraine
- Lab Test Kits
- More
Women
- Sex
- Hormones
- Women’s Fertility
- SKIN
- Thyroid
- Weight Loss
- Hair
- Migraine
- Lab Test Kits
- Pain
- Anxiety
Pets
- Dogs
- Cats
- Horses
Lab Testing
Active Aging
Treatments
Therapies
Covid-19
Latest Medications

Goodpillrx Pharmacy's Telehealth Dept Offers Prescriptions By U.S. Licensed Doctors

Home
Shop
For Providers
About us
Contact us

Generic selectors

Exact matches only

Exact matches only

Search in title

Search in title

Search in content

Search in content

Search in excerpt

Post Type Selectors

product

product

post

post

page

page

product variation

product_variation

Filter by Categories

Uncategorized

Uncategorized

Men
- SEX
- Low Testosterone
  - Lab Testing
- SKIN
- Hair
- Anti-Aging Kits
- Pain
- Weight Loss
- Anxiety
- Migraine
- Lab Test Kits
- More
Women
- Sex
- Hormones
- Women’s Fertility
- SKIN
- Thyroid
- Weight Loss
- Hair
- Migraine
- Lab Test Kits
- Pain
- Anxiety
Pets
- Dogs
- Cats
- Horses
Lab Testing
Active Aging
Treatments
Therapies
Covid-19
Latest Medications

Men
- SEX
- Low Testosterone
  - Lab Testing
- SKIN
- Hair
- Anti-Aging Kits
- Pain
- Weight Loss
- Anxiety
- Migraine
- Lab Test Kits
- More
Women
- Sex
- Hormones
- Women’s Fertility
- SKIN
- Thyroid
- Weight Loss
- Hair
- Migraine
- Lab Test Kits
- Pain
- Anxiety
Pets
- Dogs
- Cats
- Horses
Lab Testing
Active Aging
Treatments
Therapies
Covid-19
Latest Medications

Goodpillrx Pharmacy's Telehealth Dept Offers Prescriptions By U.S. Licensed Doctors

Men
- SEX
- Low Testosterone
  - Lab Testing
- SKIN
- Hair
- Anti-Aging Kits
- Pain
- Weight Loss
- Anxiety
- Migraine
- Lab Test Kits
- More
Women
- Sex
- Hormones
- Women’s Fertility
- SKIN
- Thyroid
- Weight Loss
- Hair
- Migraine
- Lab Test Kits
- Pain
- Anxiety
Pets
- Dogs
- Cats
- Horses
Lab Testing
Active Aging
Treatments
Therapies
Covid-19
Latest Medications

Bronchitis MIF

"*" indicates required fields

Name*

First Last

Email*

Phone*

Address*

Street Address City State ZIP Code

What is your date of birth?*

MM slash DD slash YYYY

What is your height?*

What is your weight?*

What is your gender?*

Male

Female

Are you currently breastfeeding, currently pregnant, or may become pregnant in the near future?*

Yes

No

Not sure

Please list all medications prescribed to you even if you don't take them every day. Include vitamins, and dietary supplements. Enter medicines including name, dose, frequency, and reason for taking.*

Please list your allergies, including any allergies to medications.*

Are you complaining of a cough?*

Yes

No

Does anything come up (sputum) when you cough?*

Yes

No

What color is the sputum?*

Have you had any headaches, nasal congestion and/or sore throat with your cough?*

Yes

No

Do you have any wheezing?*

Yes

No

How long have you been experiencing your symptoms?*

Less than 3 days

3-7 days

1-4 weeks

1-3 months

More than 3 months

Are you having any difficulty breathing?*

Yes

No

Does your difficulty breathing get worse with exertion?*

Yes

No

Do you smoke tobacco?*

Yes

No

On Average, how many cigarettes do you smoke in a day?*

Fewer than 10

11-20

21-30

30+

Have you had a fever?*

Yes

No

What was your most recent temperature reading?*

Are any of the following symptoms present?

Feet swelling

Food regurgitation

Heart palpitations

Post-nasal drip

Heartburn

Difficulty swallowing

Chest pain

Diarrhea

Coughing up blood

Have you been diagnosed with any of the following?

Chronic obstructive pulmonary disease (COPD)

Asthma

COVID-19

HIV

Autoimmune

Thyroid disease

Cardiovascular disease

Coronary artery disease

Seizures

Kidney Disease

Low potassium

Glaucoma

Diabetes mellitus

Have you been around anybody that has been sick in the last few weeks?*

Yes

No

Have you been vaccinated for pertusis? Known as DTaP and Tdap.*

Yes

No

Provide a recent heart rate and blood pressure measurement. This can be from a recent appointment (within the past 6 months) or you can have these measured for free at most local pharmacies such as CVS or Walgreens.

Finally, is there anything else we should know?*

Yes

No

Please briefly explain.*

GoodpillRx is dedicated to helping our patients have access to quality, affordable medications, delivered straight to their door.

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