I am a male 18 years of age or older.
I have read and agree to Waiver of Liability.
I understand the side effects of this medication and adverse effect.
I understand that MWC does not prescribe Minoxidil to anyone under age 18.
I understand MWC does NOT prescribe Minoxidil Online to Women as Male Pattern Hair loss can be a sign of serious and life-threatening underlying disease and even cancer in women.
I understand must NOT use Minoxidil if have heart disease, liver disease, kidney disease, pheochromocytoma, past stroke, or are on high blood pressure medication
I do not have any of the contraindications to therapy.
I understand them maximum oral dose is 2.5mg daily and depending on tolerance must not be combined with topical minoxidil
I understand that my credit card will be billed $49.95 plus either Regular or Express processing for the consultation if approved. If not approved there is no charge for the consultation. If approved I understand I am not purchasing medication from Medical Wellness Center but rather the online consultation service. I purchase the medication from the local, brick-and-mortar United States pharmacy where the prescription is forwarded and filled. The initial consult, if approved, is a prescription for three months of oral minoxidil treatment. I understand that by submitting this form it's an "electronic signature" of a binding agreement that I agree to pay the $49.95 plus either Regular or Express processing fee if approved. I understand that there are no refunds for any circumstances even if I later change my mind and decide not to fill the prescription or use the medication or I am advised not to use this medication by another physician. I understand that whether I choose to fill the prescription or not or whether I change my mind and decide not to take the medication, there are absolutely NO refunds for the online consultation fee. Also, if the pharmacy refuses to fill a valid prescription issued by Medical Wellness Center due to do failure to verify your billing/shipping/& or Credit card information that you provided to the pharmacy or failure of your payment authorization to them we do NOT refund the consultation fee.
I have answered all the questions truthfully and I understand that by clicking submit I agree to all the terms and conditions including that my credit card will be charged the above stated amount for the consultation if approved.