勃起功能障碍药品处方申请表- BCDrugs      ED Prescriptions Form
在医生审阅问卷及批准处方后,我们的工作人员会以邮件方式通知您付费。本表格在平常情况下
可以替代医生电话或视频就诊。本文档含有您个人隐私信息,不要发给任何人。
You will be contacted via email regarding payment details once our doctors have approved your
prescription application.
Usually, doctors will make decisions about your application according to the information provided in
the questionnaire. Please do not share this document with others for your privacy.
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请确保表格填写完整。Please fill required fields completely.                                                           您只需填写本问卷一次,并每年更新,以及在健康状况发生改变时及时更新。    
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