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Genital Herpes
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    Please note that you will need to submit this form in order for a provider to review it. If you just curious about the questions, then you do not need to submit the form.
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    In order to use Choix, you do need to agree to our legal terms. If you want to review them then head over to our legal section or if you have any questions, please send us a note at support@mychoix.co.

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    Choix only operates in a select number of states. If you state isn't listed then unfortunately we don't provide care there just yet.
    • California
    • Colorado
    • Illinois
    • Maine
    • New Mexico
    • Virginia
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    Choix can only provide genital herpes care for patients that are seeking medical care within the following states and age groups.

    - California, Colorado, Illinois,  New Mexico (18 years old or older) and Maine

    This unfortunately means that we will not be able to meet your needs at this time. Please follow up with your health care provider.

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    Thank you for your interest in Choix. We currently cannot offer treatment for patients who have not been diagnosed with herpes by a medical provider. For your safety, we recommend you seek in person care with a medical provider when you have symptoms of an outbreak.

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    Please select all that apply.
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    Please list approximate date that a medical provider diagnosed you with herpes.
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    Please select all that apply.
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    Thank you for your interest in Choix. We currently cannot offer treatment for patients with certain medical conditions. For your safety, we recommend you seek in person care with a medical provider.

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    Please select all that apply.
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    Please select one.
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    And we have reached the halfway point. 😎  Just a few more questions to go. 

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    List medication name, dose, and describe side effects and or allergy symptoms you experienced.
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    For example, history of migraine headaches, high blood pressure, kidney disease, etc
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    Please also include any over-the-counter medications and herbal dietary supplements that you are taking.
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    Please select all that apply.
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    Out of pocket, $10 - $19 for 30 day supply. You will be able to select the brand on the next screen.
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      • HSV Consultation
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