Men’s health: erectile dysfunction

Share the nature and duration of your symptoms, medical history and current medicines. Your doctor assesses whether remote treatment is appropriate.

Is this service right for you?

Adult men seeking a non-emergency assessment. Cardiovascular history and medicines are important parts of the review.

Before your appointment

Prepare a full medication list, including as-needed medicines, and relevant information about your health and previous treatment.

Men’s health: erectile dysfunction — pre-appointment questionnaire

Complete the screening questions honestly. Your answers are saved before the next step. Booking opens only when the required screening answers allow it; otherwise you will receive instructions for clinician review. A clinician makes all treatment decisions.

This form is for non-emergency care and is not monitored continuously. Do not wait for a form response if you need urgent care. In an emergency, call 112.

Your contact details

Use the same name, email address and telephone number when booking in Vello so Medibem can match your questionnaire to your appointment. Do not enter your Finnish personal identity code or banking details.

Full name *

Email address *

Telephone number *

Information for your doctor

Answer as accurately as you can. If a question does not apply, say so. You may leave optional questions blank if you are unsure. A doctor will review your situation; this form does not diagnose a condition or confirm suitability for treatment.

Are you a biological male aged 18 or older? *

Yes

Not sure

Automatic booking is paused for this answer. Contact Medibem on +358 46 903 8621 so a clinician can review your answers and advise on the appropriate care. This does not mean that care has been refused.

Do you use nitrate medicines for chest pain, regularly or as needed? *

Yes

Not sure

Have you had a heart attack or stroke within the past 6 months? *

Yes

Not sure

Has a doctor advised you to avoid physical exertion or sexual activity? *

Yes

Not sure

How long have you experienced erectile difficulties?

Do you experience normal morning erections?

Yes

Not sure

Describe your erectile difficulty.

What medical conditions have you been diagnosed with?

Do you smoke or use nicotine products?

Have you tried medicines for erectile dysfunction? Describe their effects and any side effects.

List any drug allergies.

Please give details of any medical conditions, current medicines, allergies or answers above that need explanation.

Is there anything else you would like the doctor to know?

Medibem stores these answers in its website form records for appointment preparation. They are not sent to Vello in the booking link and are not automatically added to Kanta. Read the privacy notice or contact Medibem if you have questions about how your information is handled.

Before you continue *

I confirm that my answers are accurate. I understand that Medibem will store them for clinician review, that screening does not confirm treatment suitability, and that submitting this form does not create an appointment or arrange a callback.

Every appointment starts with a clinical assessment. A prescription or certificate is issued only when the doctor considers it appropriate. You may be advised to attend an in-person appointment or have tests.

Men’s health: erectile dysfunction

How we can help

Is this service right for you?

Before your appointment