Disclaimer

BY SUBMITTING THIS FORM, I AGREE TO ALL THESE TERMS AND CONDITIONS AS STATED BELOW:

1. I agree not to take any over-the-counter medicines without approval from my pharmacist
2. I will not cancel my order through my bank without consultations with Confidentialrx accounts department.
3. I understand that due to security reason, Confidentialrx does not keep my credit card data. Therefore, I will login to my account at Confidentialrx.biz, and make all refill(s) by myself. I will not contact support department to refill my order via emails.
4. I agree to monitor my health and stop taking the medication if my health deteriorates.
5. I have read, understand and agree to the Shipping & Reshipping, Returns, Refunds and Cancellations Policies of, Confidentialrx.
6. I have read, understand and agree to the Patient Responsibility Statement as stated below:

I am a competent adult at least 18 years of age.

I am permitted by law in my locale to receive the medication(s).

I am requesting for my personal medical and therapeutic purposes.

I, the patient, have had a satisfactory and sufficient physical examination and medical history evaluation by my personal family physician within the last 6 months who is available and whom I agree to contact for any necessary local follow-up care and intervention, in case i have any difficulties, possible complications, or questions. I know also that I may contact the prescribing physician and the dispensing pharmacy, and I will keep those toll free numbers available.

I have been fully informed by appropriately trained health care personnel and understand the risks, benefits, and possible side effects of the prescription drug(s) I may request, I have studied written or internet materials on these drugs including the websites and links that offer in-depth material.

I also affirm that I have previously safely used the medication(s) I may request, under a physician's supervision, or I been advised by my examining physician that the use of the medication(s) is not contraindicated for me and is appropriate for my personal therapeutic and medical needs.