CONSENT TO USE PERSONAL INFORMATION

For all prescription medications a written prescription from your physician is required. I hereby appoint www.buydapoxetine.ca. and its delegates (buydapoxetine.ca) as my agent and attorney for the purposes of obtaining a prescription from a medical that corresponds to the prescription included in this order. The acts authorized may include directly contacting my prescribing medical practitioner, and purchasing and arranging delivery of the medications prescribed in the prescription, substantially on the terms set forth in this contract, and all to the same extent that I could if I personally took such steps. I hereby consent to and authorize buydapoxetine.ca, the Doctor and any pharmacy with which buydapoxetine.ca may partner (the “Partnered Pharmacy”) to collect my personal medical information and to maintain on file the information necessary to verify and process future orders, including but not limited to my name, address, phone number and payment information. I understand that my personal information will be handled only by buydapoxetine.ca, the Doctor, and the Partnered Pharmacy’s processing employees and contractors (including physicians and nurses, pharmacists and pharmacy technicians).

WAIVER AND RELEASE OF OBLIGATION

I hereby release and hold harmless buydapoxetine.ca, its Partnered Pharmacy, the Doctor, their officers and directors, agents, employees and contractors (including physicians and nurses, pharmacists and pharmacy technicians) from any and all suits, demands, liabilities, claims, actions, expenses, losses and damages of any kind or nature whatsoever, including, without limitation, general, direct, special, indirect and consequential damages and costs of litigation (including reasonable attorney fees)arising from:

1. The manner or timeliness of completion by buydapoxetine.ca or its Partnered Pharmacy of any of the actions I have authorized; and
2. My use of the medication(s) provided to me by buydapoxetine.ca’s Partnered Pharmacy including, without limitation, any and all side effects whether previously known or unknown;
3. My breach of any terms, conditions or representations or warranties in this agreement.

REPRESENTATIONS AND DISCLOSURE

I represent that all of the following statements are true and understand that buydapoxetine.ca, it’s Partnered Pharmacy, their employees and contractors (physicians and nurses, pharmacists and pharmacy technicians) will consider the following, when obtaining a prescription for me:

1. I will immediately contact My Medical Practitioner in the event I suffer any unexpected side effects from any medication(s) provided to me by buydapoxetine.ca’s Partnered Pharmacy. buydapoxetine.ca has made no representations or warranties to me, including, without limitation, representations or warranties regarding the use or fitness for any particular purpose of the medication(s) delivered (including, without limitation, its appropriateness for curing or helping relieve any particular ailment, illness or disease, or its potential or actual side or adverse effects whether previously known or unknown).
2. I place this order for medication for my sole use and I will not provide any of this medication to another person. I am not seeking or relying on any medical information from buydapoxetine.ca.
3. I will use any medication obtained for me by buydapoxetine.ca strictly in accordance with the instructions provided by My Medical Practitioner.
4. The prescription that I am requesting buydapoxetine.ca to assist me in obtaining has not been altered in any way nor has it been filled prior to submission to buydapoxetine.ca. I agree to immediately destroy all copies of my prescription once it has been filled.
5. A duly qualified medical practitioner in My Place of Residence (“My Medical Practitioner”) prescribed the pharmaceutical product(s) (“the Ordered Product”) that I am requesting buydapoxetine.ca to assist me in obtaining.
6. I can make my own medical decisions according to the laws of My Place of Residence.
7. I am of the age of majority or older according to the laws of the state in which I reside (“My Place of Residence”).

TERMS OF PURCHASE AND SALE AGREEMENT

1. If I choose to pay for my order by credit card, buydapoxetine.ca and the Partnered Pharmacy will charge my credit card the following amounts (all prices in US funds):
   1. The medication price as posted on buydapoxetine.ca website on the day buydapoxetine.ca receives my order,
   2. A $0 Shipping/Insurance Fee for each package buydapoxetine.ca ships; and
2. I am solely responsible and take full possession of my order at the time of shipment (or point of origin) from buydapoxetine.ca and its Partnered Pharmacy(s).
3. buydapoxetine.ca will not exchange medication or return any monies paid once an order is filled, unless the medication provided to me by the supplying pharmacy does not correspond with my prescription.
4. buydapoxetine.ca is not providing its services as agent or limited power of attorney as a substitute for health care or the advice of a licensed medical practitioner.
5. buydapoxetine.ca does not fill any orders using child protection packaging.
6. Whenever possible, and unless otherwise instructed by My Medical Practitioner or by myself, buydapoxetine.ca’s Partnered Pharmacy will substitute lower cost generic drugs for any prescribed brand name prescription drugs.
7. buydapoxetine.ca reserves the right, in its sole discretion, to refuse to process any order, in which event I will be entitled to a prompt refund of all monies paid for such order, if any.
8. In the event my payment is not authorized by my credit card company, buydapoxetine.ca has the right to cancel my order and attempt in good faith to promptly notify me of such cancellation.

By clicking above, I agree to all of the above terms and conditions on behalf of myself, my heirs, assigns and successors. I further represent that I understand all of the terms and conditions and that I have had adequate opportunity to consult any advisors necessary, whether medical, legal or otherwise. In the event that I am placing the order on behalf of someone else, I also represent that I have all necessary consent, permission and authorization to do so on behalf of that person and their heirs, assigns and personal representatives.