I, the undersigned, confirm and agree that my use of the prescription refill
function located at larkdrugs.com/prescriptions is voluntary and I accept and
assume any and all risk associated with this method of communication regarding
my prescription refill requests.

 

I further verify that because all communications by this method are initiated by
me it in no way constitutes a solicitation for goods or services on behalf of Lark
Drugs Pharmacy.

 

I understand that Lark Drugs Pharmacy takes the utmost care and consideration
regarding my Protected Health Information (PHI) and privacy and continually
monitors such communications for unauthorized activity.

 

This agreement shall remain in effect until such time as I choose to revoke it by
written notification.