By using this Site, undertaking an online medical consultation and purchasing treatment from this Site, I affirm and state truthfully as if I was under oath that:
I am at least 18 years of age and an adult of sound mind and judgement.
I am permitted by the laws in my residing country to receive the treatment and medication that I am requesting for my personal use, and I enter into this Agreement in compliance with the laws of my country.
I, the patient, have recently undergone an examination with a local Doctor or my General Practitioner (GP) who has evaluated my current condition and past medical history and deemed this to be to a satisfactory level.
My local Doctor or GP is a registered medical practitioner who is available for a further consultation if the need arises and I agree to immediately contact my Doctor for any necessary check-up, care or intervention in the event that I should experience any side effects or complications or have any questions in respect of the medication(s). The prescribing Doctor and the dispensing pharmacy may also be contacted and I will email them accordingly to arrange for the prescribing Doctor or the dispensing pharmacy to call me back, if the need arises. I accept that the prescribing Doctor or an appointed representative may contact me for any reason whatsoever even if I have not requested them to do so.
The prescription and medication that I am requesting are entirely for my own personal medical needs and my own personal use, are required for my condition and will not be used to sell onto any third party or used to stockpile an excess of medication beyond an adequate supply.
I agree and understand that the purpose of this service is to support, not replace, the relationship with my healthcare providers, local Doctor or GP.
I have been informed by an appropriately trained health care professional and fully understand the benefits, possible side effects and risks of the prescription treatments I may request. I have also studied written or online materials on these medications including various links and websites that offer in-depth material on the subject.
I may have used on previous occasions the medication that I am requesting under a Doctor's supervision and its use was safe and free from side effects. I also state that my local examining Doctor or GP advised me that the use of the medication is not contraindicated for me and is appropriate for my personal medical needs.
By completing this consultation and anything associated here forth, I am requesting that a UK- or EU-registered prescriber act only in an adjunct capacity to my local Doctor or GP. I do not wish for this registered prescriber to replace my local Doctor or GP. As a result I confirm that I am requesting that the registered prescriber considering my consultation issue the prescription for dispensing by the associated licensed pharmacy.
I will immediately contact a local Doctor or my GP for any necessary medical intervention should a complication or side effect manifest whilst using the medication or at any time thereafter. Before taking any other new medicines, I agree to first obtaining approval from a registered medical practitioner or pharmacist and take full responsibility in this regard. I agree to fully disclose to this practitioner the list of medications that I am currently taking including the one being ordered from this Site.
I have answered and will answer all questions answered truthfully and to the best of my knowledge, in the same way I would answer in a ‘face-to-face’ consultation with my local Doctor or GP.
I understand that full disclosure is essential in maintaining my personal safety and I will without fail adhere to this condition of disclosure at all times.
As a further affirmation of the aforementioned point, I confirm that I have disclosed in full any and all information concerning my health and medical history that may be relevant to my request for treatment and medication. I have not omitted or misrepresented any information or statement of fact during the consultation process and relevant hereto.
I fully understand that there are risks as well as benefits associated with and in relation to the use of any medication or treatment. I affirm that I have undergone a recent medical examination with respect to my physical and medical condition.
I agree to monitor my blood pressure and will do so at least once every 7 (SEVEN) days. I agree to stop taking the medication immediately if my blood pressure is higher than 140/90 (if the top number is greater than 140 or the bottom number is greater than 90). I will stop taking the medication immediately and will consult a Doctor or my GP as soon as possible and without any further delay.
I am permitted by law to use the credit card and or any other payment card that will be used to purchase the medication or treatment, if my request is approved and processed. I affirm that I am an authorised cardholder or signatory and or duly authorised to use the payment card used on this Website.
I have not been induced or placed under duress to use this Site, undertake an online medical consultation and or purchase medication or any other treatment that I requested or may request and I do so out of my own free will and choice.
By proceeding with this request for the chosen treatment or medication, I am voluntarily agreeing to all of the above-mentioned points. I understand that by using this Site and the service it provides, I irrevocably bind myself to the Terms and Conditions contained herein.
Last updated 25 November 2015.
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