Create AccountStep 1 of 5 First Name Last Name Email Address * Password * Consultations and Medicine Arrangement 1. Introduction This Mandate (“Mandate”) is a legal agreement between PEPTO GENIX, a registered business under South-Africa’s laws, and its clients. This Mandate outlines the terms and conditions under which the Company agrees to arrange and pay for medical consultations and medicines on behalf of its Clients. 2. Scope of Services 2.1 Medical Consultation Arrangement The Company agrees to arrange for medical consultations with licensed healthcare providers on behalf of its Clients as requested. 2.2 Medicine Arrangement and Payment The Company agrees to arrange and pay for prescribed medicines as per the healthcare provider’s recommendations. The Company shall not be liable for the availability or efficacy of any prescribed medication. 3. Limitation of Liability 3.1 Medical Decision Disclaimer The Company is not a healthcare provider and does not make medical decisions. All medical consultations and prescribed medications are the responsibility of the licensed healthcare provider. 3.2 No Guarantee of Outcomes The Company does not guarantee the success or outcome of any medical consultation or treatment, nor does it assume liability for adverse effects resulting from any treatment or medication. 4. Client Responsibilities 4.1 Accurate Information The Client agrees to provide accurate personal and medical information to facilitate the arrangement of appropriate consultations and treatments. 4.2 Compliance with Prescriptions The Client agrees to adhere to prescribed treatments and dosages provided by the healthcare provider. 5. Confidentiality The Company shall ensure the confidentiality of the Client’s medical information, complying with all applicable privacy laws (POPIA). 6. Termination The Company reserves the right to terminate this Mandate at any time if the Client fails to comply with the terms herein or if the Company determines the services are no longer feasible. 7. Amendments The Company reserves the right to amend this Mandate as necessary. Clients will be notified of any material changes. 8. Governing Law This Mandate shall be governed by the laws of South-Africa. Acknowledgment *Confirm By using the Company’s services, Clients agree to the terms and conditions outlined in this Mandate. Pepto Genix Pepto Genix is committed to protecting your privacy. We understand that your personal medical information is sensitive, and we take all necessary steps to ensure that it is kept safe and confidential. Referrer Details Patient Details When you provide us with your personal medical information, we will only use it to provide you with the peptide injections that you have requested. We will not share your information with any third parties without your express consent. ID Number * Cell Phone * Medical HistoryTo help us provide you with the best possible service and care, please tell us more about your medical history. To help us provide you with the best possible service and care, please tell us more about your medical history. What is your Height? * What is your Weight? * What is your ideal Weight? * Do you have any chronic diseases? If yes, please elaborate. * 0 characters Do you have or had thyroid disease? If yes, please elaborate. * 0 characters Do you have any allergies? If yes, please elaborate. * 0 characters Are currently on any medication? If yes, please elaborate. * 0 characters What is your abdominal circumference (cm)? The measurement should be taken at the level of the belly button. Privacy Clause. Pepto Genix is committed to protecting your privacy. We understand that your personal medical information is sensitive, and we take all necessary steps to ensure that it is kept safe and confidential. Confirmation * I accept these Terms and Conditions Thank You! PreviousNext Submit
