Questions Related to Travellers Diarrhoea

In order to prescribe treatments for Travellers diarrhoea our doctor needs some information regarding this specific condition. Please complete the following as accurately as possible.

Which country/countries are you travelling to?

Are you pregnant, trying to conceive or breastfeeding?

Yes No

Do you suffer from any renal or hepatic impairment?

Yes No

Do you suffer from any condition affecting the tendons or nervous system?

Yes No

Do you have any kind of blood disorder, also known as porphyria?

Yes No

Do you have epilepsy or myasthenia gravis?

Yes No

I understand that I should seek further medical advice if ciprofloxacin does not cure my diarrhoea after 3 days of treatment.

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