ACKNOWLEDGEMENT AND CONSENT BY CUSTOMER
As a material inducement for the services to be rendered by Troy Pharmacy, I do hereby acknowledge and agree that:
1. I am above the age of eighteen (18) years, and have entered into a contract with Troy Pharmacy of my own free will, and that I did not act under duress or undue influence.
2. I acknowledge and confirm that any medication provided to me shall be for my exclusive personal use, and that I shall use it as directed. I shall not pass it on to other persons, or be party to reselling the medication.
3. I have undergone a physical examination by a physician licensed to practice medicine in my state (herein after called the 'Primary Physician') and that the Primary Physician has diagnosed a certain medical condition which has resulted in the Primary Physician facilitating a secure prescription to be sent to Troy Pharmacy for dispensing. Therefore I am utilising the services of Troy Pharmacy to obtain medication for the identified medical condition and not for a medical condition which has not previously been diagnosed as a result of a physical examination by a physician licensed to practice medicine in my state.
4. I confirm that I will use the medication dispensed by Troy Pharmacy only after consultation with my Primary Physician and that should the Primary Physician recommend that I discontinue the treatment, or alter it, or in any way supplement or reduce it, my Primary Physician's advice regarding the prescribed medication shall be observed by me.
5. Therefore, I hereby agree to indemnify and hold harmless Troy Pharmacy and the pharmacist who may hereafter fill the prescription against any and all liability arising from any condition that I might suffer following medication dispensed by Troy Pharmacy.
6. I further warrant that I have checked to ensure that the importation of prescription drugs into my state of residence does not violate the laws of my state or any state at which I may accept delivery of medication dispensed to me by Troy Pharmacy.
7. I understand that the Primary Physician is not an employee of Troy Pharmacy and that, therefore, no vicarious inability shall attach to Troy Pharmacy for any acts or omissions of the Primary Physician.
8. . I understand that in using the facilities of Troy Pharmacy the contents of my medical history becomes the property of the Primary Physician and of Troy Pharmacy. I also acknowledge that Troy Pharmacy has the right to store this information, place it at the continuing disposal of the Primary Physician, any other persons involved in my treatment, and to continue to copy, retain and use the said information and records relating to me.
9. I agree that any and all disputes, controversies and claims arising out of or relating to this use of the services provided herein, or concerning the respective rights or obligations of the parties, shall be settled and determined by arbitration with the Commercial Panel of the American Arbitration Association in accordance with the Commercial Arbitration Rules. All Arbitration claims shall be filed with the American Arbitration Association at it's Southfield, Michigan office, or in the event that such an office is no longer in existence, then the closest office to Southfield, Michigan. Claims covered by this agreement to arbitrate include, without limitation, tort claims and claims for violation of any federal, state, or other governmental law, statute, regulation or ordinance. In preparation for the arbitration hearing, each party may utilize all methods and scope of discovery authorized by the Michigan Rules of Civil Procedure. The arbitration award shall be final and binding upon the parties and a judgment may be entered upon it in accordance with applicable law in any court having jurisdiction thereof, including a federal district court, pursuant to the Federal Arbitration Act.
10. Regarding my treatment, received through Troy Pharmacy, I confirm that;
a. I shall seek information from my Primary Physician regarding the risks, benefits, and possible side effects of any medication dispensed by Troy Pharmacy.
b. I will use such medication under the strict supervision of my Primary Physician, whose advice shall take precedence.
c. I undertake to make contact promptly with my Primary Physician or any medical practitioner for any necessary emergency intervention should a complication arise following my use of the prescribed medication.
d. I appreciate that there are always attendant risks to the use of any medication. I hereby indemnify Troy Pharmacy and/or the Primary Physician from liability if any severe or other side effects should result from my use of the prescribed medication. I personally accept all risks involved in taking the prescribed medication.
e. I appreciate that no health professional may guarantee that the medication prescribed shall have the desired effects or will provide the results I seek.
f. I understand and agree that: Troy Pharmacy shall not be liable for any acts or omissions of my Primary Physician in advising me or communicating with me with regard to the prescribed medication.
g. The liability if any, of Troy Pharmacy shall extend only up to such amount as may represent the purchase price of any medication and products concerned in any relevant transaction.
11. I agree to release Troy Pharmacy, its employees, agents, principals, corporate affiliates and all related parties from any liability arising from my consumption of prescribed medications and for medical, physical or behavioural and other effects of any medication that I may take as a result of my being dispensed medication by Troy Pharmacy.
12. I agree that if any court should find any part or provision of this agreement to be void or unenforceable, the void or unenforceable part of the agreement shall be excised from the whole agreement, the remainder of which I accept shall remain binding on me, and of full force and effect.
Consent To This Agreement
What information are you collecting and how are you collecting it?
Every computer connected to the Internet is given a domain name and a set of numbers, that serve as that computer's "Internet Protocol" or IP address. When a visitor requests a page from any Web site within the Troy Pharmacy Network, our Web servers automatically recognize that visitor's domain name and IP address. The domain name and IP address reveal nothing personal about you other than the IP address from which you have accessed our site.
Our Web servers also collect information about the type of Internet browser you are using, operating system, as well as which of Troy Pharmacy's Web pages you have accessed. This information is used to help our team develop Web sites to display properly for the majority of our visitors.
Our Web servers do not automatically record e-mail addresses of the visitors.
Accepting cookies through your browser is a personal choice. You can sill enjoy Troy Pharmacy's Web sites if you choose not to accept cookies.
What information do you collect when I complete the "Contact Us" form?
Any information supplied through our contact forms is used to aid our business to respond to your request and provide you with the necessary information.
Your email address may be entered to receive Troy Pharmacy's electronic newsletter. You can un-subscribe to this Newsletter at anytime.
Will you disclose the information you collect to outside third parties?
Troy Pharmacy will not sell or otherwise provide the information we collect to outside third parties for the purpose of direct or indirect mass email marketing.
Troy Pharmacy will disclose personal information and/or an IP address, when required by law or in the good-faith belief that such action is necessary to:
What safeguards are in place?
Troy Pharmacy is obligated to protect your personal information by making reasonable security arrangements against such risks as unauthorized access, use, collection, disclosure or disposal. Security measures have been integrated into the design, implementation and day-to-day operating practices as part of Troy Pharmacy's commitment to protect the personal information it holds.
What else should I know about my privacy when online?
Please keep in mind that whenever you voluntarily disclose personal information online - for example through e-mail, discussion lists, or elsewhere - that information can be collected and used by others. In short, if you post personal information online that is accessible to the public, you may receive unsolicited messages from other parties in return.
Ultimately, you are solely responsible for maintaining the secrecy of your personal information. Please be careful and responsible whenever you're online.
Consent To This Agreement