Order Form

RxDutyFReePharmacy has designed its ordering mechanism to provide you, the customer, maximum security. We have deliberately abstained from the use of a shopping cart system in order to avoid storing your credit card information anywhere, neither on this site or on any third party credit card processing site.  We are using the latest encryption technology and the submission of your credit card information is received in two separate e-mails which further avoids the chance of interception.

Please complete all required information including the acceptance of the site’s “terms and conditions”.  All prices listed on this site are subject to currency fluctuations which is why prior shipping any order, you will receive a “final quotation” in US Dollars for your approval. No order will be processed, charged or shipped without your accepting the final quotation and delivery terms.

Should you have any questions, please feel free to use our contact form

Thank you for using RxDutyFreePharmacy.

ORDER FORM

Order form
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Please Select Medication 1
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Select Medication 2 (if desired however not be the same as medication 1)
Select Medication 3 (if desired however not be the same as medication 1 and 2)
  1. Custom Order
  2. Please enter your comments or remarks pertaining your order in the box here below
Prescription and payment requirements
  1. This form is part 1 of a 2-part form. Upon submission, you must complete the second form so that your order may be validated. Please note that your credit card information is encrypted and our ordering system is designed to split this information in 2 separate emails to provide you maximum security avoiding the chance of interception.
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  • Our Commitment to Quality

    U.S. Import regulations allow a consumer to order up to ninety (90) days supply for personal use ONLY. 


    
 RxDutyFreePharmacy.com is your convenient, safe and private source for brands, European and Indian, fully laboratory researched drugs at a fractional cost of U.S. brands counterparts.

    RxDutyFreePharmacy.com offers you GUARANTEED savings of upto 90%!!!

    

All prices shown in this website are in US dollars (unless otherwise stated).

    The drugs featured vary in country of origin. While some are U.S. brands, others originate from countries such as European Union, Turkey or India. All medications listed on this site have been fully laboratory tested to guarantee that their composition is equivalent to their US counterpart.
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