Patient Agreement
I acknowledge and agree with AmericaSaveOnMeds as follows:
1) I am 18 years old or older in the jurisdiction where I reside.
2) I have fully and accurately disclosed my personal and medical information and consent to its use by the pharmacy and its employees and agents.
3) I authorize the pharmacy dispensing my medication to take all steps, sign all documents and to act on my behalf as if I were personally present and acting myself for the limited purposes of (a) obtaining a prescription for any prescription which I have sent the pharmacy; and (b) packaging my prescriptions and having them delivered to me.
4) Title to my medications passes from the pharmacy to me when they have left the pharmacy location. All agreements reached or contracts formed with the pharmacy shall be deemed to be made in the United States and the laws of the United States shall have sole and exclusive jurisdiction over any dispute arising between myself and the pharmacy, it’s affiliates, parent company, related companies, subsidiaries, officers, directors and employees.
5) This agreement shall apply to every sale by the pharmacy to me and may not be altered unless in writing and signed by both the pharmacy dispensing my medication and me.
6) I acknowledge that due to the nature of the products ordered, all sales are final and I cannot return products for a refund or exchange. By signing this agreement, I confirm I have read and understood these terms and that my information is true and correct. Furthermore, I agree that the terms herein are binding on me and my heirs, assigns, successors and personal representatives.
CALL TOLL-FREE: 1-844-252-5050.
FAX TOLL-FREE: 1-844-252-6060.
By typing my name in the refill form below, I confirm I have read and understood these terms and that my information is true and correct. Furthermore, I agree that the terms herein are binding on me and my heirs, assigns, successors and personal representatives.