Terms and conditions

(all fields are mandatory)

I am a licensed Canadian physician.* This field is required

I will not share my password.* This field is required

I understand that this program is for compassionate use only.* This field is required

Requests submitted are for patients whom to the best of my knowledge are not covered by a drug reimbursement plan and cannot afford the medication and/or insurance co-payment fee.* This field is required

I acknowledge that only one order per patient may be submitted at a time.* This field is required

This program provides free prescriptions for the specified duration. An order may be re-submitted following this period should the patient continue to meet the Program’s criteria, and can't afford the medication and/or insurance co-payment fee.* This field is required

I acknowledge that delivery may take up to 4-6 weeks.* This field is required

I will edit my profile accordingly, should my personal contact info change (i.e. address, etc).* This field is required

I acknowledge that my identifying personal information will be shared with a third party supplier in order to fulfill my orders. Personal information will only be used for order validation and shipping.* This field is required

I will report any adverse reactions to products that I am made aware, which I can do through MedEffectTM Canada and/or the company which manufactures the product.* This field is required

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