UTI Symptom Checker

Have you tried the pharmacy first service at your local pharmacy?

They provide an excellent service and can issue you with antibiotics for your symptoms.

It is often much faster to use this service.

The pharmacist will ask you about your symptoms in order to give the right advice.

If you are experiencing any of the following symptoms you should speak to your local community pharmacy team before contacting your GP.

Burning or stinging sensation on passing urine
Need to pass urine frequently
Need to pass urine urgently

Only if you have any of the following symptoms, should you continue with this form.

Blood in urine
New one sided side/back pain
Nausea or vomiting
High Temperature
Confusion/agitation

Symptom checker for UTI

Please complete the form below if you think you may have a UTI (urinary tract infection) that cannot be treated through pharmacy first.

PLEASE BE AWARE

These requests are only processed between 8am and 3pm each day, any requests for treatment received after this time will be processed the next working day.

First Name

Surname

Date of birth

Please use format day/month/year e.g. 12/05/1979

Phone Number *

Email *

Enter Email

Do you feel well enough to be treated at home with a prescription for antibiotics?

Yes

Please check the symptoms that apply to you.

A need to pee more often than usual

Pain or discomfort when peeing

Sudden urges to pee

Feeling as though you’re unable to empty your bladder fully

Pain low down in your tummy

Urine that’s cloudy, foul-smelling

Feeling generally unwell, achy & tired

How many UTI’s have you had in the last year?

Are you pregnant?

Yes

Are you allergic to any antibiotics?

Yes

How would you like to collect your prescription?

Collection from Reception

Collect from your preferred Pharmacy

This form collects your name, date of birth, email, other personal information and medical details. This is to confirm you are registered with the practice, to allow the practice team to contact you and also to update your medical records held by the practice and our partners in the NHS. Please read our Privacy Policy to discover how we protect and manage your submitted data.

I consent to the practice collecting and storing my data from this form.

I understand the practice will be in touch by close of business today either by text or call to offer the appropriate treatment, if form has been received by 3pm.