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CanadaInternationalRx.com
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Privacy Policy: Our customers' personal information is gathered only to establish a profile that helps us provide a fast and efficient service. We will not use the information for any advertising or other purpose, nor will we share it with any third parties. You will retain your complete privacy while taking advantage of any and all the services we offer.

To register as a new customer, fill in the form below. Items listed in bold must not be left blank.

Personal Information:
Login ID: Recommand using e-mail address as login ID.
Password   4 to 10 characters or numbers.
Verify Password   Match exactly.
Title
Last Name
First Name
Middle Name
Gender
Birth date DD/MM/YYYY

Contact Information:
Address (line 1)
Address (line 2)
City
State/Province
Zip/Postal Code
Country
Home Phone Number only digits, no space. eg.4164446666
Other Phone Number only digits, no space. eg.4164446666
Fax Number only digits, no space. eg.4164446666
E-mail

Primary Doctor Information:
Doctor Last Name
Doctor First Name
Doctor's Phone Number only digits, no space. eg.4164446666
Doctor's Fax Number only digits, no space. eg.4164446666
Doctor's E-mail
Doctor's Address
Doctor's City
Doctor's State/Prov.
Doctor's Zip.



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 GlobalCanadaRx nor this website has made any representations or warranties whatsoever. Without limiting the generality of the foregoing, neither GlobalCanadaRx nor this website has provided any representations or warranties of merchantability, fitness for a particular purpose or diagnosis. Further, neither GlobalCanadaRx 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 GlobalCanadaRx 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.
The use of this website and all agreements relating thereto are governed by the laws of the Province of Ontario. Any actions commenced with respect to this website or GlobalCanadaRx shall be adjudicated in the Province of Ontario. All users agree to attorn to Ontario for these purposes.


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Oct 1st. 2004.