Patient Agreement (Prescription Medication)
1. | I confirm that I have had a recent appointment with my own doctor. |
2. | IÂ require the particular medicines which I have ordered solely for my personal use and I agree not to give, sell or pass them to any other person. |
3. | I agree to carefully read all product packaging and labels prior to use. |
4. | I understand that I must consult my doctor before taking any new product. |
5. | I confirm that I have answered all questions truthfully and to the best of my knowledge. |
6. | I understand that if I supply incorrect information it could lead to inappropriate advice being given to me or the wrong medicine being prescribed, which could be harmful to my health. |
7. | I have been fully informed and understand the risks, benefits and any possible side effects of the medicines that I request. |
8. | Should any complications or side effects develop I agree to immediately contact a doctor for advice or assistance. |
9. | I will inform my own doctor about the medicines that I have received. |