The commission will endeavour to contact you at your preferred time but it may not always be possible
Confirmation Required
If you proceed with an order, our doctor will call you on the below number to explain potential side effects and answer any questions you may have. Please ensure that your phone number is correct as the doctor cannot write a prescription without speaking with you first.
Answer seven quick questions about your general health to get the most effective clinically proven treatments for you.
DO YOU AGREE AND CONSENT TO THE FOLLOWING?- I live in Australia.
- I shall be the sole user of any medication offered to me through this service.
- I confirm all answers are provided by me, and will be truthful.
- I agree to the terms and conditions.
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1
Would you like to skip the questionnaire and speak with a Doctor instead?
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2
Do you take any regular medications, have any known allergies or any medical issues?
3
Please list any regular medications you take, any known allergies or any medical issues.
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1
Do you have a hypersensitivity to tretinoin or any of the ingredients in the formulation or are you pregnant or breastfeeding?*
2
Do you have any allergies or special medical conditions? *
3
Please enter any allergies or special medical conditions *
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4
Do you take any medications?*
5
Enter any medications you take or have previously taken *
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12
Please upload a photo of your Dark Spots
6
How long have you had dark spots?*
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7
Has it ever been checked by a GP or skin cancer doctor?*
8
What did your GP or skin cancer doctor say after examining you?*
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7
Please acknowledge that you will see your GP or skin cancer clinic for check-up or examination if it does not clear up in the next 2-3 weeks.*
4
Please enter your date of birth. *
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Please use this format (DD/MM/YYYY)
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5
Discretion is at the heart of what we do but for legal reasons the name on your prescription must be your full legal name. Please provide your legal name as per your official government ID. *
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6
Based on your medical history and individual needs, our doctors have provided personalised treatment. Please complete your mobile phone number to view recommended treatment. *
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15
Do you have a Medicare card?
15
Please enter your Medicare Card details
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15
What is your IHI?
Your IHI is located next to your Covid vaccine certificate. If you are an international student or working visa holder, for our doctors to write a prescription, you first need to register for myGov and an IHI (Individual Health Identifier). You can do this all online within minutes. Please take a look at the Services Australia website for complete instructions, click here.
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4
Do you have a medication preference?
5
Enter the name of medication below
6
Please select your preferred strength
7
Have you taken 100mg before?
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6
How many uses?
7
Do you prefer?
Unfortunately based on your answer you would not be suitable for treatment. If you would like to speak with the Burst doctor to discuss other treatment options, please book an appointment here.
If you made a mistake, you can go back and correct your answer.
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Thank you for filling out the form.
It has been sent to our doctor for review.
That date isn't valid. Check the month and day aren't reversed.
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