An estimated 25,000 prescriptions for ViagraŽ are filled each day. In order to receive your ViagraŽ order, we ask that you please complete the following fast and easy process:

All prices are in Canadian currency.  Once approved for a ViagraŽ prescription, we will have your ViagraŽ order shipped discreetly to your home or office.

I hereby release this website and all of their employees and contractors including physicians from all liability associated with my ViagraŽ consultation and/or the use of ViagraŽ.  I understand that no physician, nurse or administrative personnel can guarantee that ViagraŽ, 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 this website with my complete and accurate medical history or become aware of any changes in the future which I have not notified this website of then I cannot hold them responsible for any adverse effects I may suffer.

I realize Erectile Dysfunction (ED) may be caused by underlying medical conditions such as but not limited to cancer, diabetes or conditions involving the cardiovascular system.  ViagraŽ may control your (ED) but it does not treat these possible-underlying conditions.  I also understand that cardiovascular events can be associated with sex and other strenuous activities with or without the medication.

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 ViagraŽ 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 ViagraŽ so they may advise to continue or discontinue the use of medication.

I further agree if I am taking nitrates in any form, even occasionally, I should not take ViagraŽ.   Nitrates are found in many prescription medications that are used to treat angina or chest pain due to heart disease.  I will take precaution concerning the transmission of sexual diseases and I will seek immediate medical attention if an erection persists longer than three hours.  I understand that ViagraŽ is to be taken only once per 24-hour period and the standard dose is 50mg.  Finally, I understand a qualified licensed physician, who may or may not be licensed to practice medicine in my Providence, will evaluate the information I am providing.

If approved, I irrevocably appoint this website to be my agent and have my prescription and any refills filled by the Pharmacy of its choice and acknowledge that the prescription obtained for me is non-transferable.