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Informed Consent
THE PATIENT / UNDERSIGNED, BEING OVER THE AGE OF 21, HEREBY:I the patient / undersigned accept, understand, and agree to the following companies agreement: GHSales.com, Internet Ikon Holding’s Inc, Wholesale Supplements Inc, Discount Nutrition Inc, Global Health & Nutrition Inc and it’s affiliated companies or websites.
I the patient / undersigned am freely seeking medical consultation via the Internet on my own accord. I the patient / undersigned accept, and agree that I completely understand the english language. I the patient / undersigned am aware that the licensed prescribing physician is acting only in accordance to the terms and conditions that I accept, agree, and understand to under this agreement. I the patient / undersigned , understand, and agree that the licensed prescribing physician is not rendering or providing any service or advice to me whatsoever and is solely relying on my primary licensed physician's judgement and professionalism whose care I am currently under. I the patient / undersigned have undergone all necessary blood tests and physical examinations required to administer Hgh (human growth hormone) which I the patient / undersigned have requested from the licensed prescribing physician. I the patient / undersigned have been deemed eligible and meet all the requirements to administer hgh (human growth hormone) and cleared by my primary licensed physician whose care I am currently under to administer hgh (human growth hormone) or medication that I have requested from the licensed prescribing physician. I the patient / undersigned accept, agree, and understand that the licensed prescribing physician will not consider the consultation by way of the Internet to be an appropriate and adequate means of evaluating my condition. The licensed prescribing physician will review the medical information and agreement that I the patient / undersigned have agreed, understood, and accepted to by submitting this agreement via the Internet. After the licensed prescribing physician has reviewed the agreement and all necessary documents required the licensed prescribing physician will prescribe the medication requested HGH (human growth hormone) by the patient / undersigned . I the patient / undersigned will not make a claim that the licensed prescribing physician acted unprofessionally, improperly, or below the standard of care solely because the physician did not personally perform a physical examination on me. I the patient / undersigned accept, agree and understand that I will be monitored as required by the prescribed medication (HGH human growth hormone), by my primary licensed physician and undergo all required blood tests, necessary examinations and conduct regular physical examinations that is required by the medication (HGH human growth hormone) prescribed to me by the licensed prescribing physician;
I the patient / undersigned understand that my medical evaluations, recommendations, diagnoses, and treatments will be reviewed by a physician who is licensed. I the patient / undersigned acknowledge and agree that I, under no duress, initiated contact with GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, or it’s affiliated companies, or websites. I the patient / undersigned am aware that my licensed prescribing physician may be located in another state/province or country other than my own and that the licensed prescribing physician may NOT be licensed to practice medicine in my state/province or country of residence;
This consultation and treatment recommendation constitutes a legitimate physician-patient / undersigned relationship in the state / province or country where the licensed prescribing physician is licensed to practice medicine;
I the patient / undersigned acknowledge as if under oath that it is essential that I agree, understand and provide truthful answers to the questions or agreements provided through out this site. The licensed prescribing physician evaluating my medical information will make a decision based upon my honest responses to the questions and agreements regarding my request. I the patient / undersigned take a solemn oath that the agreement I submitted via the internet is truthful, accurate and complete on the questionnaire and agreement. I further understand that failure on my part to provide truthful, accurate and complete information in detail to the licensed prescribing physician could cause him/her or the pharmacist to make an inappropriate treatment decision that could severely affect my physical or mental health and in some cases cause death.
I the patient / undersigned am under the care of my primary care licensed physician and do not consider the licensed prescribing physician to be my primary care licensed physician. I will not rely on or substitute the advice given by the licensed prescribing physician should it be contrary to or in conflict with the advice given to me by my primary care physician. Before taking any medication prescribed, I will ensure that I have completed a comprehensive physical examination by my primary care licensed physician;
I the patient / undersigned further agree to make GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc , it’s affiliated websites and the licensed prescribing physician and pharmacist aware of any changes in my medical condition or medications;
I the patient / undersigned have been advised and made aware of the risks, benefits, alternatives to, and potential side effects of this medication and have had the opportunity to ask any questions that I may have had regarding my health situation and/or treatment;
I the patient / undersigned understand and accept that it is my responsibility to consult with my primary licensed physician to ensure that I do not have a condition which will make use of this medication inappropriate or dangerous;
I the patient / undersigned have consulted with my primary care licensed physician and / or pharmacist and am not currently taking any medication or combination of medications that will make the medication I am requesting inadvisable or contraindicated;
I the patient / undersigned accept, agree and understand that it is my responsibility to notify my primary care licensed physician that I am taking the medication that I requested so that they may advise me as to whether or not I should continue or discontinue its use;
I the patient / undersigned accept, agree and understand that GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, or it’s affiliated companies or websites do not practice medicine. I the patient / undersigned understand that GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it’s affiliated companies or websites is a Management Service Organization that received my request for a physician consultation and, in turn, directs that request to a qualified independent physician for review and response. The prescribing licensed physician who reviews questions and agreements and who makes the medical determination as to whether or not I receive the medication I am seeking is solely an independent contractor of GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, affiliated companies or websites and is not an agent or employee of GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, its affiliated companies or websites. GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc its affiliated companies or websites does not direct, control or influence the treatment decisions made by the licensed prescribing physician with respect to my care and/or my request from GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc its affiliated companies or websites is not liable for any negligent act or omission of the licensed prescribing physician;
I the patient / undersigned accept, agree, and understand that my medical record becomes the property of the licensed prescribing physician, GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc its affiliated companies or websites, and in addition, the above mentioned companies and websites will have continuing access to and the right to copy and retain any and all portions of my medical records;
The patient / undersigned acknowledges that it is illegal to attempt to obtain a prescription medication for any reason by providing false or misleading information or by any other means of deception; In consideration of GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, or it’s affiliated companies or websites undertaking to render the undersigned / patient any administrative or any other services relating in any way to this agreement, or GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc it's affiliated companies or websites disclosing information or methods of treatment to patient / undersigned (either of which are deemed sufficient consideration for this agreement), then in the event any court determines that the undersigned / patient sought medical treatment or medical prescriptions through GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites for the possible or apparent purpose, directly or indirectly, of deception, assisting any investigation, or rendering of any type of assistance to, or disclosing of any information pertaining to GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites its procedures, officers, directors, consultants, or medical protocols, to any news organization, possible or actual competitor, any type of governmental agency, any investigator or any party for possible or apparent purposes of securing any information, confidential or otherwise, about GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites, its president, officers, directors, shareholders, affiliates, banking relationships, independent contractors, couriers, medical laboratories, licensed prescribing physicians, physicians, pharmacists, medical protocols, sources of pharmaceuticals, or proprietary medical treatment protocols, then the undersigned / patient knowingly, expressly and irrevocably consents to a judgment in favor of GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites, its president, directors, officers, or any party proceeding under the authority of this instrument, of liquidated damages, jointly and severally against the undersigned patient, as well as any express or apparent principle (including patient's employer), as an authorized or apparent agent of his/her principle or employer, in the amount of six million dollars ($6,000,000), which liquidated damage amount is hereby accepted by the patient / undersigned as a reasonable amount for engaging in such acts of deception and because they are difficult to ascertain. The undersigned / patient, if engaging in such deception or any of the above described acts, agrees on behalf of him/her self and his/her principle, to pay all reasonable attorney's fees and costs incurred by any person or entity seeking to enforce this agreement;
The patient / undersigned also agrees that if the licensed prescribing physician approves the patient / undersigned for a requested prescription medication, then the medication and prescription charges will be deemed to be earned and will be immediately due and payable and not refundable. In the case that the patient is denied the prescription medication requested there would be no administrative fee charged;
I the patient / undersigned accept, understand, and agree that any and all contracts and agreements formed throughout the course of the relationship between the patient / undersigned and GHSales.com, Internet Ikon Holding’s Inc,Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites, its president, officers, directors, shareholders, affiliates, banking relationships, independent contractors, agents, couriers, medical laboratories, licensed prescribing physicians, physicians, pharmacists, medical protocols, or any sources of pharmaceuticals, shall be deemed to have been made in the Province of Alberta and accordingly shall be governed by the laws of the Province of Alberta and the laws of Canada as applicable to such contracts and agreements.
I the patient / undersigned accept, understand, and agree that if any disputes whether civil or criminal arise between the patient / undersigned and GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites, its president, officers, directors, shareholders, affiliates, banking relationships, independent contractors, agents, couriers, medical laboratories, licensed prescribing physicians, physicians, pharmacists, medical protocols, or any sources of pharmaceuticals, that all law shall be governed by the laws of the Province of Alberta and the laws of Canada applicable to contracts / agreements formed in the Province of Alberta and I the patient / undersigned understand, accept, and agree that the Courts of the Province of Alberta, Canada shall have sole and exclusive jurisdiction over any dispute whether civil or criminal.
This agreement represents the complete and entire agreement between the patient / undersigned and GHSales.com, Internet Ikon Holding’s Inc, Discount Nutrition Inc, Global Health & Nutrition Inc, it's affiliated companies or websites, presidents, officers, directors, shareholders, affiliates, the patient, the undersigned, banking relationships, independent contractors, couriers, medical laboratories, licensed prescribing physicians, physicians, pharmacists, medical protocols, sources of pharmaceuticals, or proprietary medical treatment protocols and all parties mentioned above;
I the patient / undersigned accept, agree, and understand that by checking the indicated necessary marked boxes required, that I the patient / undersigned accept, agree, and understand all the terms and conditions of this agreement, and once the order is submitted via the internet I the patient / undersigned accept, agree, and understand that this agreement is considered fully enforceable.
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