PLEASE READ AND AGREE TO THE FOLLOWING WAIVER
I
hereby release Lipitor
Online Pharmacy.com,
including all of it's employees and contractors including
physicians, pharmacists, pharmacy technicians, nurses, and
receptionists from any and all liability whatsoever associated
or connected to my medical consultation and/or the use of
any or all the medications prescribed to me and any adverse
effects I may suffer from these medications. I hereby
state that I am at least eighteen years old and am fully competent
to make my own health care decisions. I am aware of the potential
side effects and or problems associated with prescription
medications. I understand that it would be a violation of
the law to falsify information on my medical questionnaire
for the purpose of obtaining prescription medication. I agree
to truthfully and to the best of my knowledge answer all of
the questions on my medical questionnaire.
I understand and acknowledge that medical diagnoses, treatments,
and opinions differ among the very best, well-trained, and
respected physicians, that there is no, nor can there be,
any implied warranty to we, that treatments may benefit one
patient and not another, that these opinions may differ from
time to time depending upon many factors such as medical research,
conventions, literature, or other physicians, etc. I understand
the risks. Any and all questions that I have about my prescription
medications and their attendant risks have been answered to
my satisfaction. I understand that all of the possible risks
and or complications that may occur that have never been recorded
before.
I also fully understand and agree that if I fail in any way
to furnish my complete and accurate medical history, or I
become aware of any changes in my physical or medical condition
in the future and I fail to notify of such changes, then I
agree that I am solely responsible for any adverse affects
I may suffer from taking or continuing to take these prescribed
medications or from participating in this prescription service.
I also state that I have had a physical examination by the
physician whose care I am under within the last twelve months.
By signing each of these pages of this waiver, or by clicking
"I AGREE" if being submitted electronically, I agree to release
liability and hold blameless the physicians, affiliates, directors,
officers, employees, representatives, and independent contractors
from all causes of action, suits, penalties, liens, judgements,
liabilities, obligations, losses, actual or consequential
damages, actual or threatened claims which may arise at any
time by reason of relating to, arising directly or indirectly
out of any matter whatsoever related to the prescribing or
dispensing of my prescription medications.
I understand that it is my responsibility to have regular
physical examinations by the U.S. licensed physician whose
care I am under including all suggested testing by said physician
to ensure I have no medical problems which would constitute
a contradiction to me taking the medications being prescribed
for me.
I also agree that should I suffer any adverse effects while
taking these prescribed medications that I will immediately
contact the U.S. licensed physician whose care I am under.
Should I come under the care of another physician, I will
inform him or her of any and all medications I am taking which
have been prescribed.
I hereby give permission to perform a medical consultation
on me for the purpose of determining if the medications I
am currently prescribed by my US licensed physician whose
care I am under. I understand that this will include reviewing
my medical questionnaire and information submitted by my physician.
If necessary, we may contact you or your physician for more
information. I hereby give permission to my physician to release
my medical files and medical reports as needed to obtain sufficient
information for the purpose of prescribing my medications.
I understand that any information provided may be seen by
the corporations' employees and that this information will
constitute a medical record.
I acknowledge and agree that I initiated this contract with
Lipitor
Online Pharmacy
and that it is not located in the United States. I acknowledge
that the physicians and pharmacists working for Lipitor
Online Pharmacy
are located and licensed to practice medicine or pharmacy
in Canada and that all treatment I am receiving from the said
physician and pharmacists is being received in Canada.
I understand and acknowledge that we recommend regular physical
examinations and doctor's office visits with my U.S. licensed
physician whose care I am under who first prescribed my medications.
I further understand that we will only verify and prescribe
medications that my U.S. licensed physician whose care I am
under has already prescribed me. We will prescribe no new
prescription medications. I also understand that no controlled
medications, narcotics, tranquilizers, or other medications
the physician decides is inappropriate. I understand that
this consultation will not include a physical examination
and that I should obtain a timely follow up consultation with
the U.S. licensed physician whose care I am under. I hereby
waive a physical examination at this time.
I understand that this service should not be considered a
substitute for a healthcare provider. I understand that this
service is not in any way intended for the diagnosis of a
medical condition. I understand that we will not make any
medical diagnoses and should not be used as a substitute for
professional medical advice. I will direct all questions to
my own health care provider. I will consult my own physician
before taking any new drug or changing my daily health regimen.
I understand that any opinions, advice, statements, services,
offers, or other information expressed or made available by
third parties (including merchants and licensors) are those
of the respective authors or distributors of such content.
This agreement represents the complete and entire agreement
between Lipitor
Online Pharmacy
and me. I have read and understood the above-referenced
"Patient Disclaimer" authorize and accept the proposed terms
of care regardless of the medical involved. I declare that
I understand.
