WAIVER
OF LIABILITY
I
hereby release www.onlinepills.com and all of their employees
and contractors including physicians from all liability associated
with my Viagra® consultation and/or the use of Viagra®.
I understand that no physician, nurse or administrative personnel
can guarantee that Viagra®, even if prescribed, will provide
the results I seek. I hereby agree to answer truthfully all
of the medical questions during my consultation. I also
understand that if I fail in anyway to furnish www.onlinepills.com
with my complete and accurate medical history or become aware
of any changes in the future which I have not notified Onlinepills.com
of then I cannot hold them responsible for any adverse effects
I may suffer.
I
realize Erectile Dysfunction (ED) may be caused by underlying
medical conditions such as but not limited to cancer, diabetes
or conditions involving the cardiovascular system. Viagra®
may control your (ED) but it does not treat these possible-underlying
conditions. I also understand that cardiovascular events
can be associated with sex and other strenuous activities with
or without the medication.
I
am fully aware that it is my responsibility to have an annual
physical exam, including any suggested laboratory test, to ensure
that I have no disease, which might make Viagra® inappropriate
for me. I also understand that this consultation is not
a substitute for my need to visit a local physician for my annual
exam. I further agree to notify all physicians, whose present
care I am currently under or any physician who I will engage
in the future, of my decision to use Viagra® so they may
advise to continue or discontinue the use of medication.
I
understand that the side effects of Viagra® include, but
are not limited to, facial flushing, mild headaches, congestion,
diarrhea, urinary tract infections and visual changes to color
sensitivity. For more information regarding Viagra� please contact
Pfizer Pharmaceuticals @ www.viagra.com.
I further agree if I am taking nitrates in any form, even occasionally,
I should not take Viagra�. Nitrates are found in many
prescription medications that are used to treat angina or chest
pain due to heart disease. I will take precaution concerning
the transmission of sexual diseases and I will seek immediate
medical attention if an erection persists longer than three
hours. I understand that Viagra® is to be taken only
once per 24-hour period and the standard dose is 50mg.
Finally, I understand a qualified licensed physician, who may
or may not be licensed to practice medicine in my state, will
evaluate the information I am providing.
If
approved, I irrevocably appoint www.onlinepills.com to be my
agent and have my prescription and any refills filled by the
Pharmacy of its choice and acknowledge that the Rx obtained
for me is non-transferable. We are unable to accept returns
or issue refunds for any orders due to the fact that this is
a prescription medication.
WITH
ALL OF THE ABOVE STATEMENTS
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