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Patient Agreement (Prescription Medication)

1)     I confirm that I have had a recent appointment with my own doctor.

2)     I 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.

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