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I understand I must read
and agree to the following acknowledgment and release form before
World Canadian Pharmacy and its Associated Pharmacy will be able
to fill any of my prescriptions. |
World Canadian Pharmacy and its Associated Pharmacy , its
affiliates and related companies, shall be hereinafter collectively
referred to as WCP&AP.
I hereby confirm that I am 21 years of age or older, or the
parent or legal guardian of a patient if under the age of 21
years, and that I am fully competent to make my own health care
decisions. I am aware of the potential side effects associated
with prescription medications and understand that it would be
a violation of law to falsify any information on my questionnaire
or other medical record for the purposes of obtaining prescription
medication. I agree to truthfully and to the best of my knowledge
answer all the questions in my medical questionnaire. I agree
that if I fail in any way to fully furnish my complete and accurate
medical history if I become aware of any changes in my physical
or medical condition in the future and I fail to notify WCP&AP
of such failure, that I am solely responsible for any adverse
effects that I may suffer from taking or continue to take such
prescribed medications.
I confirm to WCP&AP that
the pharmaceutical(s) to be delivered to me were prescribed by
a doctor licensed to practice medicine in the country, state
or other applicable jurisdiction in which the undersigned resides,
that the prescription(s) for the pharmaceuticals were lawfully
obtained from that physician and that the pharmaceutical(s) will
be used only as directed and only by the person for whom the
pharmaceutical was prescribed.
WCP&AP is required to have a licensed Canadian
Physician (the "Canadian Physician") review my
medical information for the purposes of independently verifying
whether the medications prescribed by My Own Physician
are appropriate.
By reviewing my medical information, the Canadian Physician
is not rendering or providing any service or advice to me whatsoever.
I understand that it is my responsibility to have My Own Physician
conduct regular physical examination of me, including any and
all suggested testing by My Own Physician to ensure that I have
no medical problems which would constitute a contradiction to
me taking medication prescribed for my by My Own Physician. I
agree that should I suffer adverse effects while taking any prescription
medications, that I will immediately contact My Own Physician
and that in the event I come under care of another physician,
I inform him or her of any and all medications that I have been
prescribed. I acknowledge and agree that WCP&AP recommend
regular physician examinations with My Own Physician whose care
I am under and who initially prescribed my medications.
I hereby give permission to My Own Physician to release any
and all medical information and data whatsoever which WCP&AP
shall request for the purposes of performing a medical review
to determine whether the medications prescribed by My Own Physician
are appropriate in the circumstances. I hereby give permission
to My Own Physician to release my medical files and medical reports
as needed to obtain sufficient information for the purpose of
such review.
I understand that any information provided to WCP&AP
may be seen by its employees, agents and contractors and that
this information will constitute a medical record. This information
will not be shared with any associates or third parties outside
of or not affiliated with WCP&AP.
I understand and agree that WCP&AP are located
in the country of Canada and that the Canadian Physicians and
pharmacists working for WCP&AP are located and licensed
to practice medicine and pharmacy, respectively in Canada only
and any prescription if any that I am receiving from such physicians
and pharmacists shall be deemed to be received by me in Canada.
I further understand that WCP&AP will only verify
and fill medications that My Own Physician has already prescribed
to me. I also understand that no controlled medications, narcotics,
tranquilizers or other medications that the Canadian Physician
decides is inappropriate, will be filled.
I hereby waive any requirement of the Canadian Physician under
the laws of Canada, the United States or any other country to
conduct a physical examination.
I understand and agree that the review of medical information
by a Canadian Physician is in no way intended as a means to diagnose
any medical condition and does not substitute the requirement
for me to obtain my own professional advice from My Own Physician.
I will consult My Own Physician before taking any 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 respected authors of distributors of such content.
I hereby waive my right to pharmacy counseling, as I have
previously been counseled.
I understand that World Canadian Pharmacy is a division of
Spencer Media Group Inc., and release World Canadian Pharmacy
and all associates, Spencer Media Group Inc. and all associates
and directors, as well as all associated pharmacies and companies
from all liability and error, and understand that ordering from
World Canadian Pharmacy.com and its Associated Pharmacy is done
so at my own risk.
I AGREE THAT WORLD CANADIAN PHARMACY, SPENCER MEDIA GROUP INC,
ALL ASSOCIATES, DIRECTORS, ASSOCIATED COMPANIES AND PHARMACIES,
AND THE CANADIAN PHYSICIAN SHALL NOT BE LIABLE FOR ANY LIABILITY,
CLAIM, LOSS, DAMAGE OR EXPENSE OF ANY KIND OR NATURE CAUSED DIRECTLY
OR INDIRECTLY BY ANY INADEQUACY, DEFICIENCY OR UNSUITABILITY
OF THE PRESCRIPTION ISSUED BY THE CANADIAN PHYSICIAN OR THE INADEQUACY,
DEFICIENCY OR UNSUITABILITY OF THE CANADIAN PHYSICIAN'S REVIEW
OF MY MEDICAL INFORMATION. IN NO EVENT WILL WORLD CANADIAN PHARMACY,
SPENCER MEDIA GROUP INC, ALL ASSOCIATES, DIRECTORS, ASSOCIATED
COMPANIES AND PHARMACIES, AND THE CANADIAN PHYSICIAN BE LIABLE
OR RESPONSIBLE FOR ANY DAMAGES WHATSOEVER, INCLUDING, DIRECT,
INDIRECT, PUNITIVE, SPECIAL OR CONSEQUENTIAL DAMAGES, EVEN IF
ADVISED OF THE POSSIBILITY THEREOF.
By using this site you agree to the terms and agreements between
you and WCP&AP. This agreement also governs the use
of our website worldcanadianpharmacy.com and all of its contents.
You agree to be bound by this agreement each and every time you
use this website and accept all responsibility for all charges
if any associated with connecting to WCP&AP prescription
service.
Return Policy: Due to the nature of the products, products
are not returnable, all sales are final. Sorry no refunds.
I understand that all prices will be charged to my credit
card in US dollars.
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I understand I must read
and agree to the above acknowledgment and release form before
World Canadian Pharmacy and its Associated Pharmacy will be able
to fill any of my prescriptions. |
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