Consultation

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About You

About Your Symptoms

  • Pain or tenderness on moving the ear (tragus or pinna) or jaw.
  • Itching or pain or discomfort in the ear canal.
  • Dry scaly skin in the ear canal.
  • Blocked ear canal.
  • A fever (above 38C).
  • Sudden or severe hearing loss.
  • Any swelling and/or redness (of the ear / behind the ear / of the face or neck) that is hot and/or painful to touch.
  • Clear fluid / blood or pus leaking from your ear.
  • Severe pain when moving the jaw or neck.

About Your Health

  • Kidney problems
  • Liver problems
  • A patent grommet
  • A perforated tympanic membrane

About Your Medications

About Your Agreement

  • You have capacity to understand all about the condition and the treatments available here.
  • The treatment for your own use only.
  • You give permission to access your NHS Summary Care Records (GP records) if required or applicable.
  • You have read and understood what the treatment options / benefits / risks and side effects associated with them.
  • You will read the patient information leaflet before taking the treatment and use the treatment as directed.
  • You will contact your doctor if you experience any adverse effects or symptoms change.
  • You understand that if you use this treatment with a perforated ear drum it may cause irreversible deafness.
  • You understand that if there is any chance that you may have a perforated eardrum (even one that has not been diagnosed) you need to arrange a face-to-face consultation for an examination.
  • You have answered the above assessment questions accurately and honestly.

GP Consent