Patient
Declaration
By agreeing to visit the site www.eupharma.co.uk,
you are affirming to the following:
- I have understood that www.Eupharma.co.uk is an independent online advertising medium and has no ability to operate as a pharmacy and hence, have no ability to take orders for prescription drugs and processing of orders. Hence, it is my sole responsibility to determine the accuracy and authenticity of the Pharmacy while placing an order with the pharmacy. I agree that by opting to purchase the medication, I am solely responsible for my decision.
- I have read, understand and agree to the “Terms
and Conditions” and “Disclaimer”
published on website. Further, I agree to use the website in accordance
with the stated conditions. I agree to use the website for only personal
and non-commercial purposes.
- I am a competent adult at least 18yrs 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.
Further, I indemnify www.eupharma.co.uk for any loss, claim,
damage or lawsuits resulting from any medication used.
- I, the patient, have had a recent satisfactory and sufficient physical
examination and medical history evaluation by a local physician 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 telephone 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 medication(s) I may request. I have studied written
or internet materials on possible side effects of the prescription
medication(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 have 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.
- I am requesting the prescription medication(s) solely for my own
personal therapeutic and medical needs, and will not distribute any
of the medication to others.
- I am requesting that a licensed prescriber act only in an adjunct
capacity to my local physician, and not replace my local physician,
when reviewing my request. I further request the prescriber to authorize
the prescription medication(s) for dispensing by the e-clinic's associated
licensed pharmacy.
- I affirm that I am seeking the prescription(s) for a necessary supply
of medication, not to stockpile medication beyond an already adequate
supply on hand.
- I will promptly contact my local physician for any necessary medical
intervention should a complication or concern result related to the
use of a requested medication.
- I agree not to take any over-the-counter medicines without approval
from my pharmacist who is informed of my use of this and all medications.
- I am allowed by law to use the credit card that will be used if
my request is approved and processed. Further, I agree to pay all
the charges involved and represent that the credit card company will
honor my bills.
- I realize there are risks as well as benefits to any medication,
even over-the-counter medicines. I have been fully informed of the
effects, risks, and benefits of this medication. I agree that I have
been previously and recently examined sufficiently as to physical
and medical condition, and I have been provided sufficient information
and adequately understand, the same as or more than, if this consultation
had taken place with my local physician in a physical office setting.
- I fully agree that as a customer it is my sole responsibility to
abide by the rules, taxes, and tariffs applicable in the country I
reside.
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