Become a Savings Advocate with the Canada Drugs Referral Rewards Program



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Become a Savings Advocate with the Canada Drugs Referral Rewards Program Earn 5% of your friends purchases EVEN MORE Earn of friends purchases! Find out how customers just like you can earn and save money for you, your friends and your family

Our Referral Rewards Program is designed to easily earn customers just lik you direct cash rewards when you share your experience with Canada Drugs. For every person that you refer, you ll earn a percentage on every order they ever place! You can use these reward dollars to save with us, or we ll simply send you the reward money you earned via check to thank you for being a savings advocate for Canada Drugs. How It Works $75 per month Michael Danielle $500 per month $62 per month $150 per month $137 per month 5% 5% Karen $50 per month Sheila Greg $235 per month 5% $52 in earnings monthly $96 per month 5% $40 per month $122 per month The Canada Drugs Referral Rewards Program is easy. Karen, after completing one order with CanadaDrugs. com, told her social circle about the everyday prescription savings at Canada Drugs by sharing the Referral Rewards Program package with her friends Michael, Shelia, Danielle, and Greg. By filling out the New Patient Order form, all received 25% off their first order* from Canada Drugs. Karen now earns 5% of the value of every single order her friends and family place with Canada Drugs and of their friends purchases. By simply sharing her firsthand experience with Canada Drugs, Karen is earning money each and every time her circle orders from us. Karen can use the money she earns to pay for her own orders, or she can choose to be paid out in cash by Canada Drugs. It s her money that she s earned by sharing her story. *Up to a maximum of $1000 USD.

Frequently Asked Questions How do I sign up my friends and family? As long as you have completed one order with us, you can simply have them send in the attached New Patient Order Form, or email your friends or family from www. canadadrugs.com/referralrewards when they place their first order with us, you ll start earning! You can also have your friends or family call us 24-7 at 1-800-226-3784 and use your name when they first place an order to get their 25% off.* How much can I earn? There is no limit! We want you to spread the word about Canada Drugs! We think more people need to know how to save on their lifesaving prescription medication and to thank you for sharing our story will reward you. Quite simply the more people you sign up, the more you earn. And if your friends and family start signing up their friends and family, your earnings really are limitless! Can I use my rewards for my purchases with Canada Drugs? Of course! When you call to order we ll let you know how many rewards dollars you have and we ll take that off your purchase price to save you even more money on our already low prices. Can I be sent a check with my rewards dollars? If you ve earned more than $50 in Referral Rewards, you can ask for that amount to be sent to as a check as thank you from Canada Drugs. That money is yours. You earned it! Am I charged anything to redeem my referral money? There is a $10 service fee to have your referral money paid out. This fee is to cover the administrative costs associated in preparing and mailing the check to you. There is no cost to use your rewards dollars as credit towards purchases. Why do I have to wait to accumulate $50 before I can be paid out? The reason we require you to accumulate $50 before we can issue a cheque is because of the fees that are associated with the cheque. Canada Drugs will charge a $10 service fee, and many banks in the U.S. will charge an additional fee to cash a cheque issued out of the country. In order to take advantage of the best savings available, you can simply use your credit towards your medication purchases with Canada Drugs. Is my credit transferrable to my spouse s account? Yes, you can transfer any outstanding credit on your file to another file. Why can t you add my referral money to my method of payment? The intent of our referral program is to help you reduce your medication costs. For this reason, we are unable to refund any credits earned through the program to a credit card or bank account. *Up to a maximum of $1000 USD. Visit www.canadadrugs.com/referralrewards for more information.

How to sign up for the Referral Rewards Program 1 via WEB Visit www.canadadrugs.com/referralrewards and use the online form to sign up and refer your friends and family instantly! 2 via MAIL Those you refer can send in the attached New Patient Order Form directly to us: CanadaDrugs.com 24 Terracon Place, Winnipeg, Manitoba, Canada, R2J 4G7 3 via PHONE Call 1-800-CAN-DRUG (226-3784) to speak to a representative. SAVE 25% on your first order!* All new customers who sign up for an account under the Referral Rewards Program will save 25% on their first order* with Canada Drugs. Not valid in conjunction with any other offer. *Up to a maximum of $1000 USD. No Plans, Premiums or Deductibles No hidden fees. Just Big Savings! Free Shipping Never pay a cent to have your medication delivered right to your door! 90-Day Return Policy 100% refund, plus shipping, for the cost of any medication returned. Call toll free. 24 hours a day. 7 days a week.

Referral Rewards New Patient Order Form PHONE: FAX: INTERNET: 1-800-CAN-DRUG (226-3784) 1-800-988-5440 www.canadadrugs.com Direct Dial: (204) 949-1394 Direct Dial: (204) 224-2736 Email: info@canadadrugs.com MAILING ADDRESS: 24 Terracon Place, Winnipeg, Manitoba, Canada, R2J 4G7 Referral Rewards Program Complete to earn credits for yourself and the person who referred you! Full Name of person who referred you Phone Number Please send me a Referral Rewards Program package Visit www.canadadrugs.com/referralrewards for more information Medication For medication(s) that you wish to order, please enter the quantity, and listed price, as obtained through our website or customer service center. An original prescription from your doctor s office is required (mailed, emailed or called in from your Doctor). PRICING IN $US DOLLARS. Would you like to receive a call to remind you of future refills? Yes No Please check if you are placing this order for a pet. Cat Dog Other (please specify) Pet Name: GENERIC OK? MEDICATION STRENGTH QTY PRICE Personal Information Your Full Name (please print clearly) Male Female Street Address Phone (Home) Phone (Other) Email / / Birthdate (MM/DD/YY) You will save an additional 25% OFF your first order!* *Up to a maximum of $1000 USD Payment Options (Please Select One) SHIPPING: TOTAL: FREE Best time to be contacted CREDIT CARD Visa Mastercard (We do not accept Discover or American Express) Secondary Contact Cardholder's Name Full Name of Secondary Contact Cardholder's Address Relationship To You Your Physician Primary Physician's Name Clinic Name, Street Address Phone Number Credit Card Number Expiry (MM/YY) CVV Code PERSONAL CHECKING ACCOUNT OR I will make a payment by check and mail it to: Canada Drugs 24 Terracon Place, Winnipeg, MB, Canada, R2J 4G7 Phone Number Ext. Fax Number Email Allergies Do you have any known drug allergies? Yes No If yes, please entrer the drugs you are allergic to: Medication, OTC, Herbal Products You Are Currently Taking (only list medications you are not ordering) MEDICATION DOSAGE FREQUENCY Patient Authorization (Please Check One) Canada Drugs Customer Care operates a marketing and call centre business in Winnipeg, Manitoba, Canada, specializing in the business of assisting pharmacies both within Canada and internationally pursue international prescription service pharmacy. The following terms and conditions govern the sales as between the Canada Drugs authorized dispensary (the Pharmacy ) and the individual (the Patient ) regarding the products and services (the Products ) offered for sale by the Pharmacy. The Patient herein represents to the Pharmacy that, I am over the age of majority, and: 1. I have fully and accurately disclosed my personal information and personal health information and consent to its use by the Pharmacy. I have had a physical examination by a physician within the last 12 months, and do not require a physical examination. 2. I understand that all Products shall be sold & dispensed by a Pharmacy operating within a unique international jurisdiction and in a manner consistent with the laws of that jurisdiction. 3. I authorize and appoint the Pharmacy, as my attorney and agent, to take all steps, sign all documents and to act on my behalf as if I were personally present and acting myself for the limited purposes of (a) obtaining a valid prescription for any prescription which I have sent the Pharmacy; and (b) packaging my prescriptions and delivering them to me. This authorization shall include, but not be limited to: collecting and using my personal and personal health information as reasonably necessary for the fulfillment of my order, including disclosure to a licensed physician if required for the issuance of a valid prescription in the jurisdiction of the Pharmacy. This authorization may be revoked at any time and shall continue until I revoke it. 4. I understand that the Pharmacy is legally incorporated and authorized by law to carry on business in the jurisdiction of the Pharmacy, and that I am purchasing medications that have been approved for sale in the jurisdiction of the Pharmacy. Title to my medications passes from the Pharmacy to me in the jurisdiction of the Pharmacy when my medications leave the Pharmacy. All agreements reached or contracts formed with the Pharmacy shall be deemed to be made in the jurisdiction of the Pharmacy, the laws of the jurisdiction of the Pharmacy shall govern all transactions, and I attorn to the courts of the jurisdiction of the Pharmacy, which shall have sole and exclusive jurisdiction over any dispute arising between me and the Pharmacy, its affiliates, officers and directors. I HAVE READ AND UNDERSTAND THESE TERMS AND AGREE THAT THEY SHALL BE BINDING UPON ME AND MY ASSIGNS, HEIRS AND PERSONAL REPRESENTATIVES. OR I am the parent/legal guardian/power of attorney for the Patient disclosed herein, am over the age of majority, and have full authority to sign for and provide the above representations to the Pharmacy on the Patient s behalf. Patient's Signature / / Date (MM/DD/YY) REF NUM

Prescription Submission PHONE: FAX: INTERNET: 1-800-CAN-DRUG (226-3784) 1-800-988-5440 www.canadadrugs.com Direct Dial: (204) 949-1394 Direct Dial: (204) 224-2736 Email: info@canadadrugs.com MAILING ADDRESS: 24 Terracon Place, Winnipeg, Manitoba, Canada, R2J 4G7 Please use this form to submit your prescription(s), and send it back to us to complete your order. Full Name Phone Number Order Number (if available) Option 1: Contact Your Doctor* Option 2: Transfer From Another Pharmacy* Physician's Name Pharmacy Name Clinic Name, Street Address Street Address Phone Number Ext. Fax Number Phone Number Ext. Fax Number Please list the medications you would like us to call your doctor for, or to transfer from another pharmacy. Drug Name Strength Directions Rx Number * Contacting your doctor and transferring from another pharmacy is only available to residents of the United States and Canada Option 3: Mail Your Prescription Please mail this form and your prescription to: Canada Drugs 24 Terracon Place Winnipeg, Manitoba Canada R2J 4G7 REF NUM

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