To help us understand that this treatment is the right option for you, please answer the following questions. If you get stuck or need any help, you can contact us.

0%


You have an underlying medical condition
You've been through a major surgical procedure
You have allergic reactions
You have cardiovascular conditions or might have had suffered a stroke
You suffer from a low liver or kidney function

Please provide more information of the medication being used if any.

Please select your option
Presently Pregnant
Presently Breastfeeding
Planning on getting pregnant
Neither Pregnant nor Breastfeeding

Please select your option
Male
Female
Transmale (Born a female)
Transfemale (Born a male)




If you do, please explain which drug is causing these side effects and how serious they are.


Toothache
Sensitivity of the teeth, particularly when eating or drinking something hot, cold, or sweet
Spots on your teeth that are grey, brown, or black


Providing us with your physician's address means that you allow us to share this information with him/her for updated medical records if need be. It also allows our clinician to access your medical records if there is a need for that. We advice you share this treatment with your doctor for him/her to update your medical records.
×