- You are at least 18 years old.
- You , the patient, have been fully informed and understand the risks and possible side effects of the prescription drug you request.
- You have been recently examined and advised by an examining physician that the use of the requested medication is not contraindicated for you and that it is appropriate for your therapeutic and medical needs.
- You are requesting the prescription medication solely for your therapeutic and medical needs, and will not distribute any said medication to others.
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