Get the Help You Need — Fast, Simple, and Affordable
Call or text Dr. Kaplan anytime if you have questions about which medication is right for you. The flat $79 fee covers everything — no surprise bills. You'll get a coupon and a local pharmacy will fill your prescription (Viagra or Cialis generics) for as little as 30–40¢ per tablet — often ready in under an hour.
Name
First Name
Last Name
Date Of Birth
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Day
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Date
Phone Number
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Email
example@example.com
ZIP code for your preferred pharmacy (in Nevada)
Which medication would you like?
generic viagra 50 mg
generic viagra 100 mg
generic cialis 10 mg
generic cialis 20 mg
How many tablets would you like? (Enter a number between 1 and 60)
*
Have you ever taken ED medication previously?
*
yes
no
Have you ever experienced a side effect from ED medication?
*
yes
no
Have you ever taken nitroglycerin or heart medications with nitrates?
*
yes
no
Have you had a heart attack, stroke, chest pain, or been told you have aortic stenosis?
*
yes
no
Do you have poorly controlled or uncontrolled high blood pressure?
*
yes
no
Do you have a bleeding disorder, leukemia, or multiple myeloma?
*
yes
no
Do you have severe liver or kidney disease?
*
yes
no
Do you have retinitis pigmentosa or NAION (eye disease)?
*
yes
no
Do you have a history of priapism or Peyronie’s disease?
*
yes
no
If you answered “Yes” to any of the above, please describe briefly:
Please review our
Terms & Conditions and Arbitration Agreement
before proceeding.
*
I have read and agree to the Terms & Conditions and Arbitration Agreement.
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ED VISIT
Medical Services
$
79.00
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