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Informed Consent Agreement for Viagra®I hereby release Access RX and all of its employees and contractors including physicians from any and all liability whatsoever associated or connected with my Viagra ¨ medical review and/or use of Viagra ¨. I hereby state that I am an adult and that I am aware of the potential side effects associated with Viagra ¨. 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 Viagra ¨ , even if prescribed, will provide the results I seek. Further, I understand that even if prescribed, I may suffer adverse effects from Viagra ¨. I hereby release Access RX and all of its employees and contractors including physicians from any and all liability whatsoever associated with any adverse effects I may suffer from my use of Viagra ¨. I am participating in this program at my own choice, at my own expense and my own liability and assume all responsibility for my use of Viagra ¨. I fully understand that it is my responsibility to have an annual physical examination, including any suggested laboratory tests, to ensure that I have no diseases which might make Viagra ¨ inappropriate for my condition. I further agree that I have consulted with my physician and/or pharmacist and hereby warrant that I am not taking any medications or combination of medications that are on the published list of medications which would make Viagra¨ contraindicated. I further agree to immediately notify any doctor whose present care I am under that I have chosen to take Viagra ¨ so that they may advise to continue or discontinue use. We are unable to accept returns or issue refunds for any orders due to the fact that this is a prescription medication. Customer is responsible for all customs, tariffs, and taxes, if applicable to their country.  If you have any questions, or would prefer to place your order over
the phone, you may contact us at:
Phone: 800-930-8770 Fax: 800-709-6687 
All trademarks and registered trademarks are of their respective companies. © Copyright 1999-2000, all rights reserved. No use of our html, or graphics or derivatives can be made without written permission.
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