UTI – Self Assessment

Pain relief remedies and over the counter remedies should be used first

If you have 3 or more moderate to severe symptoms your GP will consider prescribing antibiotics. Please complete the form below, so we can understand your symptoms.

If you feel severely unwell, have a high fever, or loin pain, then it is advisable to see a GP.

Please Note – once you have submitted this information, any reply or acknowledgement from us will be sent to the email address you provide at top of the form. This response may include personal and sensitive information about you. We therefore strongly advise that you provide a personal email address that only you have access to. If you do not wish for us to communicate with you via email, please do not use this form and call us instead.

UTI - Self Assessment Form
This email address will be used for all correspondence relating to this request. Please be aware that if anyone else has access to this email address that they may see responses sent to you.
Symptoms
Please tick all that apply
If symptoms are mild, a urine dipstick test may be necessary. If UTI tests are negative, you may be advised to use over the counter remedies and drink plenty of fluids.