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By the action of submitting the order form, I affirmed that I have understand and legally agree to the following terms and conditions:

	I affirmed that all orders made by me is for my personal use and administration.
	I will administer the purchased medication in accordance to the instruction given by my physician.
	I will immediately engaged and seek professional advise from physician if any form of complication should arise with regards to the purchased medication.
	I have properly checked and understood the local laws in relation to the importation of medication and affirmed that it is legal for me to do so.
	I am mature enough to order medication with the use of credit card or any kind of payment method based on my personal preference and it will not in any way infringe local laws by doing so.
	I will not hold Bellspharmacy or any associated partners responsible for any form of misuse, or legal issues in relation to the purchase of the medication.
	I fully understand that I am acting on my own accord, at my own risk and liable for my own action and take full responsibility for the purchasing and administering of my medication.
	I am fully aware that I am requesting the assistance from a licensed prescribing physician whom acts solely in an adjunct capacity. This physician should not replace my own local physician, when assessing my request and thereafter authorizing the prescription drug(s) for dispensing and subsequently my purchase from the clinic’s associated licensed pharmacy.
	I affirmed that I am seeking the prescription(s) which is of a necessary quantity based on my personal administration and not with the intention of stocking the medication beyond reasonable amount on hand.
	I have been and will be answering all queries or questions posed to me truthfully which is for the safety and interest of myself just as I would during physical examination in my local clinics or relevant establishment.
	I understand fully that there are benefits and conversely risks involved in any form of medication, even OTC drugs, despite being informed of potential effects, I have consented to the treatment upon the request.

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