By submitting this order form, I hereby certify that:
- I am at least 18 years of age.
I, the patient, have had a recent physical examination and medical
history evaluation by a physician who is available for any necessary
local follow-up care and intervention.
I have been fully informed and understand the risks, benefits, and
possible side effects of the prescription drug(s) I may request.
I have safely used the medication(s) I may request under a physician`s
supervision or been advised by an examining physician that the use of the
medication(s) is not contraindicated for me and is appropriate for my
therapeutic and medical needs,
I am requesting the prescription medication(s) solely for my therapeutic and
medical needs, and will not distribute any said medication to others.
I am requesting that a licensed prescriber act only in an adjunct capacity to
my local physician, not replace my local physician, when reviewing my request
and if authorizing the prescription drug(s) for dispensing by the virtual
clinic's associated licensed pharmacy.
I am seeking the prescription(s) for a necessary supply of medication, not to
stockpile beyond an already adequate supply on hand.
I will promptly contact a local physician for any necessary medical intervention
should a complication or concern result related to the use of a requested
I am allowed by law to use the credit card that will be used if my request
is approved and processed.
I have and will answer all questions truthfully, for my safety, just as I
would in my local physician's office and care.
I realize there are risks as well as benefits to any medication, even OTC drugs,
and having been informed of possible effects, I consent to treatment as
I may request.
I am permitted by law in my locale to receive the medication(s) I am requesting,
and I will be responsible for customs clearance and or any additional taxes
if there will be any.
I hereby confirm that I am aware that at times products might be shipped
loose and not in blister packs due high demand or lack of stock and to allow
for best possible prices
I declare that I agree for the delivery time of 10-17 business days.
I hereby confirm that I wish to receive monthly newsletters and any special
offers from this web site.
We value our customers above all else. Your privacy and protection is very important to us,
and will not be compromised. Our company and this web site maintain that your information
is safe and secure, and we have taken the measures needed to ensure this. Any information
provided by our customers is never shared, sold, or released to any third party.