Trichomoniasis Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1Patient Details2Health Inquiry3Pharmacy Details 4PaymentFirst Name *Last Name *Date of Birth *Confirm Date of Birth *Check to confirm date of birthGender *MaleMaleFemaleWeight *Height *4' 0"4' 0"4' 1''4' 2''4' 3''4' 4''4' 5'4' 6''4' 7''4' 8''4' 9''4' 10''4' 11''5' 0"5' 1''5' 2''5' 3''5' 4''5' 5'5' 6''5' 7''5' 8''5' 9''5' 10''5' 11''6' 0"6' 1''6' 2''6' 3''6' 4''6' 5'6' 6''6' 7''6' 8''6' 9''6' 10''6' 11''7' 0"7' 1''7' 2''7' 3''7' 4''7' 5'7' 6''7' 7''7' 8''7' 9''7' 10''7' 11''Email *PhoneWho is the patient? *Myself (the patient)Myself (the patient)Pediatric (2-17 yrs old)FriendSelect Your Location *TexasTexasKansasGeorgiaFloridaNevadaMississippiLouisianaAlaskaSouth CarolinaSouth DakotaAlabamaArkansasNew MexicoLet's match you with an authorized medical professional in your state.NextWhat disease are you suffering from? *TrichomoniasisTrichomoniasisAre you focused and alert? *YesNoDo you have a life-threatening symptom or a medical emergency? *YesNo life-threatening symptomsDo you have chronic Liver, Heart or Kidney problems? *YesNo life-threatening symptomsSexual Partners? *NoneNoneSingle PartnerMultiple PartnerDo you use condoms consistently ? *SelectYesNoDo you experience any of these symptoms? *Pelvic PainPain while urinatingSoresUsusal DischargeNoneHave you experienced any other symptoms? Please describe *Have you been tested for any STIs, Including trichomoniasis in the past? *SelectYesNoWe advise undergoing a lab test post-treatment to ensure the infection has been fully treated, priced at $40.00 *Select$40.00 - For me$80.00 - For me & partnerNo - I will do my own test after treatmentTo prevent reinfection, we advise treating your partner. They can receive treatment at a discounted rate of 50% *Select$17.50 - YesNoPlease choose your preferred medication , if applicable, from the treatment options provided *SelectMetronidazoleTinidazoleDoctor's choiceLab DetailsLab Location *Lab Zip Code *Partner's DetailsFirst Name *Last Name *Date of Birth *Gender *SelectMaleFemaleWeight *Terms of Use & Privacy PolicyLayout *By checking this box, I acknowledge that I have read and agree to the Terms of Use of this application.You must be focused and aware.Unfortunately we do NOT treat life-threatening conditions online. Please call 911PreviousNextPharmacy DetailsPharmacy Name *Pharmacy Address *Address Line 1Address Line 2CityState / Province / RegionAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePreviousNextConsultation FeePrice: $34.99Stripe Credit Card *PreviousSubmit