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XENICAL® ORDERING PROCESS
An estimated 40,000 prescriptions for Xenical® are filled each day. To receive your Xenical®
prescription and subsequent order, we ask that you please complete the following three step process:
- Review the reference material concerning Xenical® and agree to the Waiver of Liability.
- Complete the Medical Questionnaire.
- Select the quantity of Xenical®. If approved for a Xenical® prescription, we will have
your Xenical® shipped discretely to your home or office within 2 - 3 business days.
XENICAL® PRICES ARE AS FOLLOWS:
120 mg Xenical® Pills
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90
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120 mg
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tablets
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1 month supply
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$140
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180
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120 mg
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tablets
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2 month supply
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$280
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270
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120 mg
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tablets
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3 month supply
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$420
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CONSULTATION FEE
There is a $75.00 consultation fee ONLY if the physician determines Xenical®
is appropriate for your condition. There will be NO CHARGES if the physician determines that Xenical® is not appropriate for your condition. Your approved
Xenical® prescription allows you to place your original order plus four (4) additional orders over the next twelve (12) months.
WAIVER OF LIABILITY
I hereby release 1stxenicalprescription.com and all of their employees and contractors including physicians from all liability associated with my Xenical®
consultation and/or the use of Xenical®. I understand that no physician, nurse or administrative personnel can guarantee that Xenical®, even if prescribed, will
provide the results I seek. I hereby agree to answer truthfully all of the medical questions during my consultation. I also understand that if I fail in anyway to
furnish 1stxenicalprescription.com with my complete and accurate medical history or become aware of any changes in the future which I have not notified
1stxenicalprescription.com of than I cannot hold them responsible for any adverse effects I may suffer.
I realize obesity is associated with the following health conditions,
cardiovascular disease, strokes, diabetes, gallbladder disease, certain types of cancer, gout (joint pain caused by excess uric acid), osteoarthritis
(deterioration of the joints), sleep apnea (interrupted breathing during sleep) etc. Xenical® may assist you with weight reduction but it does not treat these possible associated conditions.
I am fully aware that it is my responsibility to have an annual physical exam,
including any suggested laboratory test, to ensure that I have no disease, which might make Xenical® inappropriate for me. I also understand that this
consultation is not a substitute for my need to visit a local physician for my annual exam. I further agree to notify all physicians, whose present care I am
currently under or any physician who I will engage in the future of my decision to use Xenical® so they may advise to continue or discontinue use of the medication.
I understand Xenical® is indicated for obesity management including weight
reduction and weight management when used in conjunction with a reduced caloric diet. The diet should be nutritionally balanced and contain approximately
30% of the calories from fat. I understand secondary to Xenical's® mechanism of action there is a decrease in the absorption of the fat soluble vitamins A, D,
E, K and beta carotene, therefore physicians recommend a daily supplemental multivitamin.
I understand the side effects of Xenical® include but are not limited to, gas with
discharge, fatty or oily stools, an increase in the frequency of bowel movements and bowel incontinence. (These side effects are generally mild and resolve
early in treatment) For more information regarding Xenical® please visit Roche Pharmaceuticals @ www.xenical.com. I understand Xenical® can be taken in
conjunction with a mildly reduced choleric diet up to 3 times per day, the standard dose is 120 mg. Finally, I understand a qualified licensed physician
who may or may not be licensed to practice in my state will evaluate the information I am providing.
We are unable to accept returns or issue refunds for any order due to
the fact that this is a prescription medication.
WITH ALL OF THE ABOVE STATEMENTS
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