Re-Order Form

Name

Email

Telephone Number

Have you had a face to face consultation from So Medical?

Are there any changes in your medical allergies or conditions?

Have you had any problems with your product routine?

Are you pregnant / trying to become pregnant or breastfeeding?

Are you currently taking any prescriptive medication including topical creams?

If yes please advise the medication you are currently taking

Are you taking any vitamin supplements?

If yes please advise the vitamin supplements you are currently taking

Are there any other particular problem areas you are concerned about?

Please add which products you would like to replenish?

Please provide any other relevant information

Please send me information about offers and other promotional materials