Check if this Medicine is Right for You

Learn about treatment options based on your goals, habits, and health history.

1️⃣ Your Health Background

Do any of these apply to you?

(Select all that apply)

A) Kidney problems or dialysis

B) Liver disease (cirrhosis, hepatitis, etc.)

C) Heart problems or heart failure

D) Drink alcohol often

E) Pregnant, planning pregnancy, or breastfeeding

F) None of the above

Other:

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Do you have any allergies?

(Select all that apply)

A) No known allergies

B) I had a bad reaction Medications before

Other:

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2️⃣How You Feel Today

Do you currently have any of the following symptoms?

(select all that apply)

A) I feel healthy and stable

B) Chest pain or pressure

C) Trouble breathing or shortness of breath

D) Feeling dizzy, faint, or confused

E) Not sure

Other:

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3️⃣Your Other Medicines

Are you taking any other medicines right now?

(Select all that apply)

A) No, I’m not taking any other medicines

B) Yes, Another medicine that doesn’t mix well with Others

C) I’m not sure if they interact, I take many medicines

Other:

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4️⃣Final Notes

Anything else you’d like us to know? (optional)

💬 Example: “I just started a new blood-pressure pill.” or " I only take Tylenol occasionally"

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Please hold on while we prepare your personalized plan 👑

Donepezil Hydrochloride