ADV-CARE Pharmacy Registration Information - Canadian online prescription and OTC drugs store in Ontario


OTC Search | Rx Search


    New Registration

   To register as a new customer, fill in the form below. Items listed in bold must not be left blank.
   All information will be kept strictly confidential. We will not communicate this information to others as part
   of a mailing list.

Personal Information: Disclaimer and Agree Group Code:

*User Name: *Password:
*Verify Password: Title:
*Last Name: *First Name:
*Birth date: *Gender:

Contact Information:

*Address:
*City: *State:
*Country: *ZipCode:
*Home Phone: Fax Number:
E-mail

Doctor Information:

For each Doctor that you are currently under the care of, please record their information on a separate Customs Statement.
 
Prescribing Doctor's
Last Name:
Prescribing Doctor's
First Name:
Doctor's Phone: Doctor's Fax:
Doctor's E-mail:
Select one: Ask your Doctor to fax your prescription
Mail the orginal prescription




You are now ready to submit your registration for approval. To submit your registration, click the Submit button.

Prior to submitting my personal profile, I acknowledge that I have read the following Limitation of Liability and Disclaimer and agree that:

1. The information available through this site is intended to assist in selecting non-prescription products and does not suggest diagnosis or treatment. This information is not a substitute for medical advice, treatment or attention.

2. I understand that neither ADV-Care Pharmacy nor this website has made any representations or warranties whatsoever. Without limiting the generality of the foregoing, neither ADV-Care Pharmacy nor this website has provided any representations or warranties of merchantability, fitness for a particular purpose or diagnosis. Further, neither ADV-Care Pharmacy nor this website represent or warrant that the information accessible on this website is accurate, complete or current.

3. Price and availability information is subject to change without notice.

4. Except as specifically stated on this site, neither ADV-Care Pharmacy nor any of its officers, directors, employees, agents or representatives will be liable for any damages of any kind arising out of, or in connection with, the use of this website. Without limiting the generality of the foregoing, there shall be no liability for damages of any kind including compensatory, direct, indirect or consequential damages for personal injury of any kind or for any reasons, including for loss of data, income or profit, loss of or damage to property and claims of third parties.

5.. I also authorize and consent to ADV-CARE Pharmacy Inc.: (i) collecting and checking the accuracy of the personal and the personal health information I have provided and will be providing in the future; (ii) disclosing the information to third parties so that such third parties may provide verification of such personal information to them from information they have previously collected about me; (iii) using the information to fill my prescriptions and to collect payment (iv) disclosing the information to other pharmacies to whom my prescriptions may be transferred or who may assist them in filling my prescriptions; and (v) keeping my information on their premises or the premises of pharmacies to whom my prescriptions are transferred or who are assisting them; (vi) transfer any of my prescriptions to my local pharmacy or a pharmacy of their choice,(vii) recieve electronc communications from ADV-Care Pharmacy by phone, e-mail, SMS, fax or any communication means or (viii) retain another pharmacy to assist them to centrally fill my prescriptions. I acknowledge that ADV-CARE Pharmacy´s collection and use of my information is subject to their privacy policy which is available at www.adv-care.com/about.htm or which can be obtained by calling this number 1-888-471-4721.I also consent to recieve electronc communications from ADV-Care Pharmacy by phone, e-mail, SMS, fax or any communication means.


      
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