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Free Eligibility Check

Check your eligibility.
Free, in a few minutes.

Four short steps covering your goal, your health profile and your details. A licensed Australian doctor reviews your information and makes contact within 24 hours. Nothing is charged and nothing is sent without your approval.

$0 upfront · Doctor contact within 24 hours · Full pricing before any payment · Australian licensed pharmacies

Your Goal - Step 1 of 4

to there your

Which area do you want help with? *

Choose the main area. You can add specific treatment interests further down.

Previous treatment experience *

New to this area
Previously used prescribed treatment
Currently using prescribed treatment

This helps the doctor understand your starting point.

In your words what do you want help with?, and is there anything specific you want considered? *

Tell us your main goal, any treatment names you have heard of or want discussed, and anything important for UHD or the doctor to know.

Name *

First

Last

Email *

We send your proposed protocol and pricing to this address

Date of Birth *

Required for the Doctor Review

Phone *

Height *

Weight *

Activity Level

Optional, but useful when preparing recovery and performance protocols.

Are you over 18 years of age?

Are you currently located in Australia and able to attend telehealth consultations with an Australian doctor?

Are you currently pregnant, breastfeeding or planning pregnancy?

Yes
No
Not applicable

Have you been diagnosed with cancer in the past 5 years, or are you currently undergoing treatment?

Do any of the following apply to you? *

Diabetes or blood sugar condition
Heart or cardiovascular condition
Liver or kidney condition
Thyroid condition
Autoimmune condition
Blood clotting disorder or blood thinners
Mental health condition under current treatment
Recent hospitalisation or major surgery (last 12 months)
None of these apply

Tick everything that applies. This goes directly to the doctor with your request.

Current prescription medications

List all current prescription medications and doses. Write none if not applicable.

Allergies or previous reactions to medications

List any known allergies or reactions. Write none if not applicable

Have you ever had side effects or concerns with any previous treatments?

If yes, tell us about the side effects or concerns

Medicare number

Required for doctor review and pharmacy ordering if your request progresses. Your details are handled securely and never shared outside your doctor and pharmacy.

Medicare expiry

The month and year shown on your Medicare card.

Medicare IRN / position number

The number beside your name on your Medicare card.

What budget range should we work within for your proposed protocol? *

Not a lock-in. This helps us prepare something realistic for you. Final costs depend on doctor review, dose and pharmacy pricing.

Would you like UHD to prepare your proposed protocol and pricing?

Yes, prepare it from my answers and email it to me
I would prefer a phone call before anything is prepared

UHD uses your answers to build a proposed protocol for you to review. It still requires doctor consult and clinical review before pharmacy can proceed.

Consent and acknowledgements *

I confirm the information I have provided is accurate and complete to the best of my knowledge.
I understand UHD BioHealth is a telehealth support service and this form does not replace medical advice, a doctor consult or clinical assessment.
I understand any proposed protocol is subject to doctor consult, clinical suitability and pharmacy availability. Treatment is not guaranteed. Help text: Please read and tick each acknowledgement before submitting your request.

Patient signature *

Clear Signature

Sign to confirm the information and consent acknowledgements above are true and understood.

Your information is handled securely and only shared with your reviewing doctor and pharmacy. Prefer to talk it through first? Book a free 15 minute call or email admin@uhdbiohealth.com.

Doctor assessment required for all protocols Treatment is not guaranteed Full pricing presented before any payment Australian licensed pharmacies only

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Check your eligibility.Free, in a few minutes.

Check your eligibility.
Free, in a few minutes.