Do you take any prescription or non-prescription medicines?

Please list all allergies that you have, including allergies to any medications or any supplements, and all other allergies.

Are you allergic to Bimatoprost (the active ingredient in Latisse)?

I understand that I must stop Latisse one month before becoming pregnant, and I cannot use this product while pregnant or breastfeeding.

Do you have a history of eye problems, such as glaucoma, high eye pressure, macular edema, or an abnormality of the lens?

I have read and understand the possible side effects of Latisse, including a risk of irritation at the eyelid margin, eyelid pigmentation, and although uncommon, a possible risk of permanent discoloration of the iris of the eye.

I would like to provide additional information / details for my dermatologist.

I understand that the prescription can be adjusted between three refill options or paused or stopped at any time. The initial default refill frequency is every month. Refills can be adjusted at any time by clicking refill settings in my dashboard.

All set. Thanks

You are not alone. Those with comparable symptoms often benefit from medication. We will now have one of the Board-Certified doctors at BoldRx.com review your consultation.