| THE UNDERSIGNED, BEING OVER THE AGE OF 21, HEREBY:
1. Represents and confirms Buy Low Drugs., along with its subsidiaries
and affiliates (herein collectively “Buy Low”) that the pharmaceutical(s)
to be delivered to the undersigned 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 pharmaceutical(s)
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.
2. Acknowledges that Buy Low and Buy Low’s employees and agents
have relied on the information and documentation provided by the undersigned
(including the Patient Questionnaire) and the undersigned represents
and confirms that the undersigned has, to the best of his/her knowledge,
fully disclosed all pertinent requested information and documentation
to Buy Low. The undersigned undertakes to notify Buy Low of any changes
to his/her physical or medical condition by providing an updated Patient
Questionnaire.
3. Understands that it is the undersigned’s responsibility to have
regular physical examinations by the a licensed physician whose care
he/she is under, including all suggested testing by said physician to
ensure the undersigned has no medical problems, which would constitute
a contradiction to him/her taking the medication(s) being prescribed.
4. Authorizes and appoints Buy Low, as his/her agent and his/her attorney
for the limited purposes of taking all steps and signing all documents
on behalf of the undersigned necessary to obtain a prescription in Canada
for the prescription sent by the undersigned to Buy Low, to the same
extent as the undersigned could do if he/she were personally present
taking those steps and signing those documents himself/herself, including,
but not limited to, collecting personal health information regarding
the undersigned directly from his/her prescribing physician or pharmacist
and disclosing personal health information to Buy Low employees, agents
and service providers, as required, for the limited purposes set out
above.
5. Authorizes and appoints Buy Low as his/her agent and his/her attorney
for the purpose of taking all steps and signing all documents on behalf
of the undersigned necessary to package or repackage the pharmaceutical(s)
and to deliver them to the undersigned, to the same extent as the undersigned
could do if he/she were personally present taking those steps and signing
those documents himself/herself.
6. Authorizes and appoints Buy Low, as his/her agent and as his/her attorney
for the purpose of taking all steps and signing all documents on behalf
of the undersigned for shipping his/her prescribed pharmaceutical(s)
to the undersigned as if the undersigned had shipped the prescribed pharmaceutical(s)
to himself/herself to the undersigned’s address.
7. Understands and acknowledges that the pharmaceutical(s) will not be
packaged in child protective packaging, and the undersigned releases and discharges
Buy Low and Buy Low’s employees and agents, from any and all causes
of action with respect to the late delivery, non-delivery or missed delivery
of the pharmaceutical(s) sent to the undersigned.
8. Acknowledges and agrees that the undersigned initiated a consultation
with Buy Low and that Buy Low is not located in the United States. The
undersigned acknowledges that the pharmacists working for Buy Low and
the physicians contracted by Buy Low on the undersigned’s behalf
are located and licensed to practice medicine or pharmacy in Canada and
that all treatment the undersigned is receiving from the said physician
and pharmacist is being received in Canada.
9. Acknowledges and agrees that any and all agreements reached or contracts
formed throughout the course of the relationship between the undersigned
and Buy Low shall be deemed to be made in British Columbia, and accordingly
shall be governed by the laws of the Province of British Columbia and
the laws of Canada as applicable to such contracts and agreements.
10. Agrees that any dispute that arises between him/her and Buy Low,
its affiliates, related companies, subsidiaries, parent company, officers,
directors, employees or agents shall be governed by the laws of the Province
of British Columbia and the laws of Canada applicable to contracts formed
in British Columbia and the undersigned agrees that the Courts of the
Province of British Columbia shall have sole and exclusive jurisdiction
over any such dispute.
11. Understands that Buy Low shall be entitled to substitute a prescription
drug with a generic drug, where available in accordance with the British
Columbia Drug Standards and Therapeutics Formulary, unless the physician
has indicated that there be “no substitution”.
12. Acknowledges and understands that once purchased and shipped, no
pharmaceutical product may be returned or exchanged.
13. Acknowledges and understands that a maximum of
a 3 month supply of prescription medication can be shipped per person. |
