Sites-MintRx-Site

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As a pharmacy and in order to adhere to HIPPA regulations, we need to have certain personal information in order to fill prescriptions. Entering this information helps us know if there are any other considerations that need to be made to protect your health and your personal information. You only have to enter this information once and then you can enjoy seamless checkouts for every future order.

First Name

Last Name

Birthday

Phone

Gender

Height

Weight

Allergies Use none if you have no allergies

Current Medications (including vitamins) Use none if you are currently not taking any medications or vitamins

Confirm Email

Password

Password length must be at least 8 characters

Password must have at least 1 special characters ($%/()[]{}=?!.,-_*|+~#)

Password must contain at least 1 letter

Password must contain at least 1 uppercase letter and 1 lowercase letter

Password must contain at least 1 number

Confirm Password

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