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The medicine comes from outside the USA. We will ship your order by registered mail. Please specify the correct shipping address and the telephone number. The average delivery time is 10-14 business days.
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Please note: We can only ship to countries listed in the Country selector.
If your country is not listed, we cannot not ship there, usually due to customs problems.
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Medical Questionnaire
Date of Birth : e.g., 06/14/1965
Gender :
 
Do you have high blood pressure? (greater than 140/90) :
I agree not to take any over-the-counter medicines without approval from my pharmacist :
I agree to monitor my blood pressure at least once every 14 days. If my blood pressure is over 140/90 (either the top number is greater than 140 or the bottom number is greater than 90), I agree to stop taking this medication immediately :
I agree to not take this medication if I am pregnant, breast feeding, or trying to get pregnant :
 
REQUIRED : Why are you requesting this medication: (e.g. hair loss, depression, etc.)
 
Please list any current medical conditions: (If none type 'None')
 
Please list all medications you are currently taking: (If none type 'None')
 
Please list all medications that you plan to take while on this program: (If none type 'None')
 
Please list all allergies (including medications): (If none type 'None')
 
Please list any surgeries: (If none type 'None')
 
Is there anything else in your medical history you deem relevant? (If none type 'None')
 
Weight Loss Specific Questions
NOTE : You must fill out this section if you are ordering a Weight Loss medication.
Please enter your height in feet and inches  :   Feet   Inches
Your Weight in pounds  :   pounds
 
  Your BMI is 
NOTE : You must have a BMI of 27.0 or greater to receive prescription weight loss medications. You cannot take weight loss drugs if you are taking antidepressants.
 
Viagra, MeltTabs and Cialis Specific Questions
Do you have any of the following conditions? Leukemia, Multiple Myeloma, Sickle Cell Disease, Peptic Ulcers, or Retinitis pigmentosa? :
Do you take any form of nitroglycerine? :
Have you previously been treated for sexual dysfunction? :
If you are over 60 years old, write the date of last heart checkup, its results and prescriptions:
 
Patient Responsibility Statement and Informed Consent
Click each link to view the documents in a pop-up window. To continue, you must agree with the following.
Click Here to Read The Patient Responsibility Statement. I Have Read, Understand and Agree :
Click Here to Read The Informed Consent. I Have Read, Understand and Agree :
Important : I agree to pay the amount above and not to cancel this transaction with my bank. I will contact buy-generic-rx.com support to resolve any problem with my order. I understand that buy-generic-rx.com may initiate a collection and submit a negative report to Consumer Credit Reporting agencies. Credit Card Fraud is a criminal offense in any country. :
 


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Your password must be different from your username. We recommend you using passwords of 5 or more characters.

Your e-mail address must be valid. We use e-mail for communication purposes (order notifications, etc). Therefore, it is essential to provide a valid e-mail address to be able to use our services correctly.

All your private data is confidential. We will never sell, exchange or market it in any way.
For further information on the responsibilities of both parts, you may refer to our
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OUR CUSTOMERS' FEEDBACK
Thank you very much for your quick delivery. buy-generic-rx has the best customer service. I was hesitant to order my medication online at first, but I am now confident. Best Regards - Micheal.

 
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