I hereby represent and confirm to Aposan International Limited, Mypharmacyexpress.com, and each of their constituent entities, as well as to each of their affiliates, associates, related companies, subsidiaries and parent companies and each of their respective directors, officers, shareholders, employees, contractors, successors and assigns (all such persons are hereafter collectively referred to as either “Mypharmacyexpress.com or the “Mypharmacyexpress.com Agents”) that:
I am delivering this Agreement to Mypharmacyexpress.com because I wish to place an Order with Mypharmacyexpress.com for certain pharmaceuticals (the “Order”), on the terms and conditions set out herein;
The pharmaceutical(s) to be delivered to me in connection with my Order (the “Pharmaceutical(s)”) were prescribed by a doctor licensed to practice medicine in the country, state or other applicable jurisdiction in which I reside or where I sought treatment;
The prescription(s) for the Pharmaceutical(s) (the “Prescription”) was lawfully obtained by me from that physician;
I will use the Pharmaceutical(s) strictly according to the instructions provided by the physician who prescribed the pharmaceuticals, as the person for whom such pharmaceutical(s) were prescribed;
I can make my own medical decisions according to the law of the place where I reside;
The Prescription has not been altered in any way nor has it been filled prior to submission to Mypharmacyexpress.com. I agree to provide my original Prescription to Mypharmacyexpress.com, by courier or by mail, in order that my Prescription be filled.
I also undertake to immediately destroy all copies of my Prescription once it has been filled;
I am not seeking or relying on any medical information from Mypharmacyexpress.com and I have consulted a qualified physician licensed in the jurisdiction where I obtained the Prescription within the last year.
I will immediately contact the physician who provided the Prescription in the event I suffer any unexpected side effects from any of the Pharmaceutical(s).
I understand that it is my responsibility to have regular physical examinations by my primary U.S. licensed physician that is responsible for my care, including all suggested testing to ensure I have no medical conditions or problems that would constitute a contraindication to me taking the Pharmaceutical(s) being prescribed; and
I acknowledge that Mypharmacyexpress.com, its employees and agents have relied on the information and documentation that I am providing (including the Order, the Prescription and Patient Information) and I represent and confirm that I have fully and accurately disclosed all pertinent information and documentation to Mypharmacyexpress.com. I agree to notify Mypharmacyexpress.com. of any changes to my physical or medical condition by providing updated Patient Information.
The authorizations and consents that I am providing herein to Mypharmacyexpress.com commence on the date I sign this Agreement and will continue until I revoke them. I understand that I can revoke the consents and authorizations I have granted at any time by giving written notice to Mypharmacyexpress.com of my intentions in that regard.