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When
you register you are required to give specific information, we expect that this
information is accurate and true. Any falsification of information to use
Myconsults.com services will result in permanent banning.
Myconsults.com does not prescribe nor dispense medication directly. An
independently contracted, U.S. licensed and accredited Physician has the final
authorization to approve or deny any prescription/(s) or treatment/(s) requests.
Any prescription medication deemed necessary and as such may be prescribed by
our network of Physicians and Pharmacies is FDA approved. Physicians within our
network are not establishing a diagnosis nor will they replace or should they be
used as a substitute for your own Primary Care Physician and/or coordinating
care specialty Physicians. The products mentioned are trademarks of their
respective owners and are not owned by or affiliated with Myconsults.com its
associates, employees, officers, owners or any of its affiliates.
The Federal Trade Commission's Children's Online Privacy Protection Act of 1998
(COPPA) requires that Web Sites are to obtain parental consent before
collecting, using, or disclosing personal information from children under 13. If
you are below the age of 21 then you cannot use this service. Do
NOT register if you are below the age of 21.
In
order to use this service you must provide the following
Current Photo Identification-we
will only accept a valid passport, driver’s licence, and state identification
card. These must be clearly legible. Our staff reserve the right to request
additional identification if necessary.
Medical History-
In order for our healthcare providers to make a proper assessment of your
emergency condition you are required to provide valid medical records relevant
to the condition that you are requesting medication for. These must be clearly
legible. If you do not have up to date medical records we can assist you as
follows
By
contacting your primary care physician
By
arranging a home visit physical examination at your cost
Physical examination
-Myconsults.com requires that you must have had a full physical examination in
the last 18 months.
Your medical record should be faxed to us using the fax cover sheet provided on
registration. Our medical records fax number is 1-800-388-4249.
By
registering to use Myconsults.com and requesting a physicians phone
consultation you meet the above criteria and accept and understand the
following.
After reviewing your medical history and/or during your physicians phone
consultation, there is the possibility that your Myconsults.com
healthcare provider may determine that you are not an appropriate candidate for
the type of medical services Myconsults.com provides. In situations where
Myconsults.com cannot offer you a treatment option, a full refund will be
credited back to your credit card, minus a $25.00 administrative fee.
By
submitting a questionnaire for review prior to a phone consultation and possible
prescription(s), I agree to release from liability and hold harmless
Myconsults.com, their affiliates, subsidiaries, directors, officers, employees,
representatives, and independent contractors from all causes of action, suits,
penalties, liens, judgments, liabilities, obligations, losses, actual or
consequential damages, actual or threatened claims which may arise at any time
by reason of, relating to, arising directly or indirectly out of any matter
whatsoever related to the prescription of my selected medication.
I accept and
understand that treatments prescribed by Myconsults.com may have side effects
that may be defined by the doctor during my consultation and will additionally
be included with my prescription. The possible side effects and complications
are being provided based solely upon the information given to Myconsults.com by
me both verbally and included in the written questionnaire provided to
Myconsults.com.
I hereby release Myconsults.com and all of their employees and contractors
including physicians and pharmacists from any and all liability whatsoever
associated or connected with my consultation and/or my use of treatments
prescribed. I hereby state that I am an adult as defined in the state of which I
reside. I understand that falsifying information in order to obtain prescription
medication is a violation of both State and Federal US law. I hereby agree to
answer truthfully all of the medical questions on my questionnaire.
I understand that no doctor, nurse, or administrative personnel can guarantee
that beneficial treatments, even if prescribed, will provide the results I seek.
Further, I understand that even if prescribed, I may suffer adverse effects from
treatments. I hereby release Myconsults.com and all of its employees and
contractors including physicians and pharmacists from any and all liability
whatsoever associated with any adverse effects I may suffer from my use of
prescribed treatments. I understand that it is my responsibility to furnish
Myconsults.com with my complete and accurate medical history and follow up
thereafter with any changes to it which occurs at a subsequent time.
I understand that the proposed consultation and care may involve risks and
possibilities of complications and that certain complications or side effects
have been known to occur in patients who take prescribed treatments even when
the utmost care, judgment, and skill are used. I acknowledge that no guarantees
have been made to me as to the results or are there any guarantees against
favourable results, risks, or complications.
I understand and acknowledge that there is no implied warranty to me and that
treatments may benefit one patient and not another. I understand that there is
no known medical treatment that gives 100% satisfaction to everyone.
I accept the risk of substantial and serious harm and/or complications from
taking treatments prescribed by Myconsults.com and their medical partners. I
acknowledge that I understand the risks. Any and all questions that I have about
treatments prescribed by Myconsults.com and its attendant risks have been
answered to my satisfaction.
I understand and agree that Myconsults.com and its employees may see any
information I provide to my physician and that such information will constitute
a medical record. I further understand and agree that Myconsults.com, my
physician, or both will maintain my medical record.
I understand and acknowledge that Myconsults.com and its physicians RECOMMEND A
PHYSICAL EXAMINATION BY A DOCTOR BEFORE I TAKE TREATMENTS PRESCRIBED BY
Myconsults.com. I understand that a telephone medical consultation will NOT
include a physical examination. I HEREBY WAIVE A PHYSICAL EXAM at this time and
AGREE to obtain a timely medical follow-up examination with a physician before I
take treatments prescribed by Myconsults.com. I also ATTEST that the medical
condition that I am self-describing is true and that the condition may be
defined as an "Emergency Medical Situation." An Emergency Medical Situation" may
be defined as "a condition of emergency in which immediate medical care or
hospitalization, or both, is required by a person or persons for the
preservation of health." This definition may be modified in meaning and or
definition to constitute the definition of a "Temporary Doctor/Patient
Relationship" in the state in which I reside and/or the doctor resides, is
licensed and or practices medicine.
I acknowledge and agree that I initiated the contract with Myconsults.com and
its physicians may be located in another state or country from my own and that
the Physician may NOT be licensed to practice medicine in my state of residence.
I AGREE THAT ALL ON-LINE MEDICAL CONSULTATIONS, DIAGNOSES, AND TREATMENTS WILL
BE DEEMED TO HAVE OCCURRED IN THE STATE WHERE THE PHYSICIAN IS PHYSICALLY
LOCATED AND LICENSED TO PRACTICE MEDICINE.
Medical records
I agree to provide Myconsults.com and
it healthcare providers with full and accurate medical history. I fully
understand and agree that if I fail in any way to furnish Myconsults.com with my
complete and accurate medical history, or I become aware of any changes in my
physical or medical condition in the future and I fail to notify Myconsults.com
or its physicians of such changes, then I agree that I am solely responsible for
any adverse effects I may suffer from taking or continuing to take treatments
prescribed by Myconsults.com or from participating in this program.
Refills
Refills were prescribed are available
a minimum of 25days after your initial order and completed telephone
consultation. No Refills will be permitted were we do not hold valid medical
records and photo identification.
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