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          <td width="100%" class="blue-txtc"><h3>e-HEALTHLINK TERMS AND CONDITIONS</h3></td>
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          <textarea rows="16" name="S1" cols="82">By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, your entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.

By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, your entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.

By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, your entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.

By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, your entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.

By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, your entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.

By entering the prescription information, you have consented to a pharmacist having access to your personal health information. If you are requesting a refill for another person, your entering their prescription number and birth date is deemed evidence of your authority to request such prescription refill.</textarea>
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          <td width="100%" class="blue-txtc" align="center"><h1>Your Personal Health Information Online  Anytime</h1></td>
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