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Candrug Health Solutions
Customer Authorization Form

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Candrug Customer Authorization

*All Rx medication requires a doctor's prescription.
Please fax prescription to 1.866.364.9985 upon completion.

By selecting 'I Agree' below, I agree to all of the following terms and conditions on behalf of myself, my heirs, assigns and successors. I further represent that I understand all of the following 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 successors.

AUTHORIZATION AND CONSENT

I hereby appoint Candrug Health Solutions Inc. ("CANDRUG.COM") and its delegates (Candrug.com) as my agent and attorney for the purposes of obtaining the products and services offered for sale by CANDRUG.COM. My prescription is filled according to the laws of the jurisdiction in which the dispensing service provider is located. All Canadian prescriptions are subject to the laws of British Columbia are filled by Candrug: 202A, 8322-130th Street, Surrey, BC Canada V3W 8J9, British Columbia License Number #V24. CANDRUG.COM is located in the country of Canada and that the physicians and pharmacists working for Candrug are located and licensed to practice medicine and pharmacy, respectively, in Canada only and any treatment, if any, that I am receiving from such physicians and pharmacists shall be deemed to be received by me in Canada. Some products are supplied by CANDRUG.COM’s partner Service Provider(s) in other international jurisdictions. Any treatment concerning products supplied by International Service Provider(s) shall be deemed to be received by me in the dispensing country.

The acts authorized may include directly contacting my prescribing medical practitioner, and purchasing and arranging delivery of the medications prescribed, substantially on the terms set forth below, and all to the same extent that I could if I personally took such steps. I hereby consent to and authorize CANDRUG.COM and its Service Provider(s) (physicians and nurses, pharmacists and pharmacy technicians, staff of fulfillment centers) 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 CANDRUG.COM, affiliated doctor(s), and the affiliated processing employees and contractors (including physicians and nurses, pharmacists and pharmacy technicians, staff of fulfillment centers).

DISCLOSURE AND REPRESENTATIONS

I represent that all of the following statements are true and understand that CANDRUG.COM, and its Service Provider(s) (physicians and nurses, pharmacists and pharmacy technicians, staff of fulfillment centers) are relying on the following representations:

1.	I am of the age of majority or older according to the 
	laws of the state in which I reside ("My Place of 
	Residence").
2.	I can make my own medical decisions according to 
	the laws of My Place of Residence.
3.	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 
	CANDRUG.COM to assist me in obtaining.
4.	The prescription that I am requesting 
	CANDRUG.COM to assist me in obtaining has 
	not been altered in any way nor has it been filled 
	prior to submission to CANDRUG.COM. I agree 
	to immediately destroy all copies of my 
	prescription once it has been filled.
5.	I will use any medication obtained for me by 
	CANDRUG.COM strictly in accordance with 
	the instructions provided by My Medical 
	Practitioner.
6.	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 CANDRUG.COM.
7.	I will immediately contact My Medical Practitioner 
	in the event I suffer any unexpected side effects 
	from any medication(s) provided to me by 
	Candrug.com's Partnered Service Provider(s). 
	CANDRUG.COM 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).

PURCHASE AND SALE TERMS

1.	If I choose to pay for my order by credit card, 
	CANDRUG.COM and the Partnered Service 
	Provider(s) will charge my credit card the 
	following amounts (all prices in US funds):
	a.The medication price as posted on 
	  CANDRUG.COM's website on the day 
	  CANDRUG.COM receives my order,
	b.A $14.00 Shipping/Insurance Fee for 
	  each package CANDRUG.COM ships; and 
	c.Any applicable taxes

2.	In the event my payment is not authorized by 
	my credit card company, CANDRUG.COM has the 
	right to cancel my order and attempt in good 
	faith to promptly notify me of such cancellation.

3.	CANDRUG.COM and its Partnered Service 
	Provider(s) reserve 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.

4.	Whenever possible, and unless otherwise 
	instructed by My Medical Practitioner or by me, 
	Candrug.com's Partnered Service Provider(s) 
	will substitute lower cost generic drugs for 
	any prescribed brand name prescription drugs.

5.	CANDRUG.COM and its Partnered Service 
	Provider(s) do not fill any orders using 
	child protection packaging.

6.	CANDRUG.COM 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.

7.	CANDRUG.COM will not exchange medication or 
	return any monies paid once an order is filled, 
	unless the medication provided to me by the 
	Partnered Service Provider(s) does not correspond 
	with my prescription.

8.	Title.
	Title to Products passes from CANDRUG.COM to 
	Customer at the time the Products leave 
	CANDRUG.COM affiliated dispensary. Ship dates 
	are estimates only. CANDRUG.COM and its 
	Partnered Service Provider(s) are not 
	responsible for delays in shipment or failure 
	to ship by estimated ship date. Customer 
	authorizes and appoints CANDRUG.COM as their 
	agent and attorney for the purposes of 
	taking all steps and signing all documents 
	on Customer’s behalf necessary to package 
	or re-package the Products in order to 
	have them delivered to the Customer, to 
	the same extent as Customer could do if 
	Customer were personally present taking 
	those steps and signing those documents 
	themselves.

9.	For all medications that are dispensed from 
	UK pharmacy affiliated with Candrug Health 
	Solutions on my behalf, I hereby appoint the 
	Royal Mail Postal Service as the agent 
	supplying these medications.

10. 	Warranties. 
	THE MANUFACTURER OF EACH PRODUCT IS 
	SOLELY RESPONSIBLE FOR ANY WARRANTY 
	ASSOCIATED WITH A PRODUCT TO THE 
	MAXIMUM EXTENT PERMITTED BY LAW, 
	CANDRUG.COM DISCLAIMS ANY WARRANTIES 
	AND CONDITIONS, EXPRESS OR IMPLIED, 
	IN RESPECT OF THE PRODUCTS AND 
	SERVICES CONTEMPLATED BY THESE 
	TERMS AND CONDITIONS INCLUDING, 
	WITHOUT LIMITATION, IMPLIED 
	WARRANTIES AND CONDITIONS OF 
	MERCHANTABILITY AND FITNESS FOR 
	A PARTICULAR PURPOSE. CANDRUG.COM’S 
	RESPONSIBILITY FOR CLAIMS IN RESPECT 
	OF THE PRODUCTS IS LIMITED TO 
	REPLACEMENT OF THE PRODUCT.

11.	Limitation of Liability. 
	CANDRUG.COM DOES NOT ACCEPT LIABILITY 
	BEYOND THE REMEDIES SET FORTH HEREIN 
	INCLUDING, WITHOUT LIMITATION, ANY 
	LIABILITY FOR PRODUCTS NOT BEING 
	AVAILABLE FOR USE OR DELAYS 
	EXPERIENCED IN CUSTOMERS RECEIVING 
	PRODUCTS THAT HAVE BEEN PURCHASED. 
	TO THE MAXIMUM EXTENT PERMITTED BY 
	LAW, CANDRUG.COM WILL NOT BE LIABLE 
	FOR DAMAGES ARISING FROM PERSONAL 
	INJURY OR DEATH, LOST PROFITS, LOSS 
	OF BUSINESS OR OTHER LOSS OR DAMAGE 
	RELATING IN ANY WAY TO PRODUCTS OR 
	SERVICES, WHETHER DIRECT OR 
	CONSEQUENTIAL, SPECIAL, INDIRECT OR 
	PUNITIVE, EVEN IF ADVISED OF THE 
	POSSIBILITY OF SUCH LOSSES OR DAMAGES, 
	OR FOR ANY CLAIM BY ANY THIRD PARTY. 
	THE FOREGOING LIMITATIONS APPLY 
	REGARDLESS OF THE CAUSES OR 
	CIRCUMSTANCES GIVING RISE TO SUCH 
	LOSS, DAMAGE OR LIABILITY, EVEN IF 
	SUCH LOSS, OR DAMAGE OR LIABILITY IS 
	BASED ON NEGLIGENCE OR OTHER TORTS OR 
	BREACH OF CONTRACT INCLUDING, WITHOUT 
	LIMITATION, FUNDAMENTAL BREACH OR 
	BREACH OF A FUNDAMENTAL TERM.

12.	Exports and Imports. 
	The Customer acknowledges that the 
	Products sold hereunder are subject 
	to applicable export and import 
	control laws and regulations and that 
	the Customer and not CANDRUG.COM is 
	deemed to import the Products into 
	the country of their shipping address 
	under these Terms.

RELEASE AND WAIVER

I hereby release and hold harmless CANDRUG.COM, its Partnered Service Provider(s), the Canadian Doctor, their officers and directors, agents, employees and contractors (including physicians and nurses, pharmacists and pharmacy technicians, staff of fulfillment centers) 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.	My use of the medication(s) provided 
	to me by Candrug.com's Partnered 
	Service Provider(s) including, 
	without limitation, any and all 
	side effects whether previously 
	known or unknown;
2.	The manner or timeliness of 
	completion by CANDRUG.COM or its 
	Partnered Service Provider(s) of 
	any of the actions I have 
	authorized; and
3.	My breach of any terms, conditions 
	or representations 	or warranties 
	in this agreement.

GOVERNING LAW

This agreement, along with any disputes that may arise, will be governed by and construed in accordance with the laws of the Province of British Columbia, Canada.
I have read and understand all of the foregoing.

I agree I do not agree

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Candrug Health Solutions Customer Authorization Form

Candrug Customer Authorization

Candrug Health Solutions
Customer Authorization Form