Using the Viagra Connect checklist
The checklist will help you assess the man’s cardiovascular health and concomitant medication use and conditions. It provides advice you can give for all men, whether or not they have been supplied with Viagra Connect. You’ll also find a tear-off slip, sign and date this and give it to the man to facilitate repeat supply.
If Viagra Connect is not suitable
Men who are not suitable for Viagra Connect should be told why and advised to see their GP. A tear off piece is included at the bottom of the checklist for this purpose. The patient can then take the slip with them to the doctor to help start the conversation.

Download the Viagra Connect Checklist
The Viagra Connect Checklist includes an assessment of the man’s overall fitness for sex and gives guidance on whether Viagra Connect is the right treatment option.
It’s important to understand if the man has any other medical issues
You may also wish to check the patient’s Summary Care Record or Patient Medication Record to check their concomitant conditions.
Always use your professional judgement when deciding whether to supply Viagra Connect. There is no requirement to use the Checklist.