Before you place your first order for Xenical you must read and agree to the following:

Disclaimer.
I hereby release EuropeanPharmacie.com and all of its employees and contractors including physicians from any and all liability whatsoever associated or connected with my Xenical® request and/or use of Xenical®. I hereby state that I am an adult and that I am aware of the potential side effects associated with Xenical®. I understand that no doctor, nurse, or administrative personnel can guarantee that Xenical®, even if prescribed, will provide the results I seek. Further, I understand that even if prescribed, I may suffer adverse effects from Xenical®. I hereby release EuropeanPharmacie.com 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 o f Xenical®. I am participating in this programme at my own choice, at my own expense and my own liability and assume all responsibility for my use o f Xenical®. 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 disease(s) which might make Xenical® 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 Xenical® contraindicated. I further agree to immediately notify any doctor whose present care I am under that I have chosen to take Xenical® so that they may advise to continue or discontinue use. I wish to have prescribed and supplied to me branded product that is as inexpensive as possible, without prejudice to the other factors that are to be considered by those prescribing my pharmaceuticals and those fulfiling the prescriptions.

Patient declaration.
I am at least 18 years of age. I am permitted by law in my country of residence to receive the medication(s) I am requesting. I have had a recent physical examination by a physician who is available for any necessary follow-up care and intervention. I have been fully informed and understand the risks, benefits, and possible side effects of the prescription drug(s) I may request. I am requesting the prescription medication(s) solely for my therapeutic and medical needs, and will not distribute any medication to others. I certify that I will use this prescription medication for, and only for, the prescribed use, and that I will not use it in conjunction with any illegal substance. I will promptly contact a local physician for any necessary medical intervention should a complication or concern arise as a result related to the use of a requested medication. I am allowed by law to use the credit card that will be used if my request is approved. I do not require a child safety cap on my medication(s) if prescribed. I have and will answer all questions truthfully, for my safety, just as I would with my own doctor. I wish to have prescribed and supplied to me branded products that are as inexpensive as possible, without prejudice to the other factors that are to be considered by those prescribing my pharmaceuticals and those fulfilling the prescriptions.I understand that if I am residebt outside the European Union that I will be responsible for any customs, tariffs, and taxes, that may arise. I certify that the foregoing statements made by me are true.

Certification and Warranty of Patient.
I hereby certify and warrant that I am an adult and will carefully read and truthfully answer all of the questions in the following questionnaire. I further certify that I will be completing this application with the purpose of employing the service of the EuropeanPharmacie.com doctor and that he will be relying on the truth and accuracy of my answers in determining whether I should have the requested prescription medication supplied to me. I understand if I have failed in any way to furnish the EuropeanPharmacie.com doctor with my complete and accurate medical history I have therefore not fulfilled my legal obligation to properly inform the doctor. I understand that if in the future my medical circumstances change in contradiction to the information I have provided that it is my legal responsibility to immediately notify the EuropeanPharmacie.com doctor and cease all use of the prescribed medication until further notification.