Disclaimer & User Agreement

Please be sure to review this DISCLAIMER AND USER AGREEMENT.

MEDICINE FROM CANADA LIMITED POWER OF ATTORNEY & RELEASE FORM

THE UNDERSIGNED, BEING OVER THE AGE OF 21, HEREBY:
1. Represents and confirms to Medicine From Canada, it's Partnered Canadian Pharmacy, its affiliates, related companies, subsidiaries and parent company (hereinafter “Medicine From Canada”) 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 Medicine From Canada and it's Canadian Pharmacies 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 Medicine From Canada. The undersigned undertakes to notify Medicine From Canada 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 U.S. 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 medications being prescribed.

4. Authorizes and appoints Medicine From Canada it's partnered Canadian Pharmacy, 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 Medicine From Canada, 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 Medicine From Canada’ employees, the Canadian Pharmacies agents and service providers, as required, for the limited purpose set out above.

5. Authorizes and appoints Medicine From Canada, and the Canadian Pharmacy 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 Medicine From Canada, and the Canadian Pharmacy 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 necessary 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, unless requested by the undersigned on the Patient Questionnaire, and the undersigned releases and discharges Medicine From Canada and the Canadian Pharmacy’ 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 Medicine From Canada and that Medicine From Canada is located in Manitoba, Canada. The undersigned acknowledges that the pharmacists working for Medicine From Canada and the physicians contracted by Medicine From Canada 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 Medicine From Canada, and the Canadian Pharmacy shall be deemed to be made in Manitoba, and accordingly shall be governed by the laws of the Province of Manitoba and the laws of Canada as applicable to such contracts and agreements.

10. Agrees that any dispute that arises between him/her and Medicine From Canada, and the Canadian Pharmacy its affiliates, related companies, subsidiaries, parent company, officers, directors, employees or agents shall be governed by the laws of the Province of Manitoba and the laws of Canada applicable to contracts formed in Manitoba and the undersigned agrees that the Courts of the Province of Manitoba shall have sole and exclusive jurisdiction over any such dispute. 

11. Understands that Medicine From Canada, and the Canadian Pharmacy shall be entitled to substitute a prescription drug with a generic drug, where available in accordance with the Manitoba Drug Standards and Therapeutic 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.

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