Companion Global Healthcare

Patients

Discount Card

IMPORTANT: Please take a minute to complete this form now, which will generate your Companion Global Healthcare Discount Card. Please complete the form and generate a card for each dependent, if applicable.

Companion Global Healthcare offers this discount card absolutely free! When you sign up for the card, you will receive details on all our value-added services, including savings on allergy control products, cosmetic surgery, hearing aids, LASIK surgery and more.

You will need to present this card at your pharmacy in order to take advantage of discounts on your medications. Once you complete this form and print out your discount card, it will be activated and you can use it immediately.

Personal Information
Companion Global Healthcare Participating Pharmacies brands
Terms & Conditions

TERMS AND CONDITIONS

Companion Global Healthcare, Inc. (“CGH”) is pleased to offer you access to the CGH network and other CGH services described on the CGH Web site (the “CGH Network and Services”). CGH is willing to provide you access to the CGH Network and Services only if you agree to these terms and conditions. Please carefully read these terms and conditions. If you so desire, you may print these terms and conditions and provide them to your legal advisor prior to consenting. If you agree to these terms and conditions, then please click the “I agree” button below. By clicking the “I agree” button below, you agree to these terms and conditions as a legal and binding agreement. If you do not agree to these terms and conditions, then you may return to the CGH Web site, but you will not be allowed to obtain use of the CGH Network and Services.

By clicking the “I agree” button below you agree as follows:

1. Payment. You agree to pay any applicable fees to any intermediary or third party contractor used in providing your access to the CGH Network and Services.

2. Healthcare and Travel Charges. You understand and agree that CGH is not providing insurance to you and is not otherwise responsible for paying any charges for medical services which you receive. You will be responsible for payment of all fees and charges for the applicable hospital or other facility which you choose to obtain services. You will need to coordinate payment arrangements directly with the hospital or other facility. This may involve coordinating with your insurer and paying any out-of-pocket amounts for which you are individually responsible. You also will be responsible for any costs of travel and lodging while receiving medical services.

3. Responsibility for Medical Services and Travel. You acknowledge and agree that CGH is only providing you with the opportunity to receive certain medical services which you choose. CGH does not engage in the practice of medicine and does not provide any advice regarding any medical services or any CGH Network hospital or facility. Any and all decisions regarding any medical services shall solely be your decision to be made after consulting with the medical health care provider of your choice. The medical care facilities in the CGH Network have been accredited through the Joint Commission on Accreditation International or its accrediting body, The International Society for Quality in Health Care (ISQua). While CGH staff has visited each of its Network facilities, CGH has not conducted an independent evaluation of the medical services at the Network facilities. Any decision regarding receiving medical services at any CGH Network facility is your sole decision and you alone must evaluate whether the facility is an appropriate place for you to receive medical services. Further, you understand and acknowledge that travel to foreign countries may involve some risk such as, but not limited to, travel accidents, acts of terrorism, war or other matters beyond CGH's control. You hereby assume all risk for and release CGH from any and all damages, claims or liabilities of whatsoever nature related to your travel and stay to receive medical services or any matter related to the medical services.

4. Confidential Information. YOU UNDERSTAND THAT IN USING THE CGH NETWORK AND SERVICES YOU MAY BE REQUIRED TO PROVIDE CONFIDENTIAL INFORMATION, INCLUDING PROTECTED HEALTHCARE INFORMATION TO CGH, ITS NETWORK FACILITIES, INTERMEDIARIES AND/OR CONTRACTORS. YOU AGREE THAT ANY INFORMATION WHICH YOU PROVIDE TO THE ABOVE ENTITIES MAY BE COMMUNICATED AND EXCHANGED FOR THE PURPOSES OF PROVIDING THE NETWORK ACCESS AND SERVICES TO YOU. YOU FURTHER AGREE THAT YOUR INFORMATION MAY BE STORED ELECTRONICALLY OR OTHERWISE.

5. DISCLAIMER OF WARRANTIES AND LIMITATION OF LIABILITY AND DAMAGES. CGH EXPRESSLY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY, WORMANSHIP OR FITNESS FOR A PARTICULAR PURPOSE. YOU AGREE THAT YOU WILL NOT HOLD CGH LIABLE OR RESPONSIBLE FOR ANY INCIDENTAL, CONSEQUENTIAL, PUNITIVE OR OTHER DAMAGES AND THAT UNDER ANY CIRCUMSTANCES, CGH TOTAL LIABILITY TO YOU SHALL BE LIMITED TO THE AMOUNT OF FEES WHICH YOU HAVE PAID TO CGH.

6. Other Important Terms. You agree that these terms and conditions set forth the entire agreement between you and CGH and that there are no other terms and conditions except as set forth in these terms and conditions. If any term or condition is held to be invalid, then the remainder of these terms and conditions shall continue to be enforceable notwithstanding the invalid provisions. You agree that these terms and conditions shall be governed by the laws of the State of South Carolina and that if you bring any suit against CGH, such suit will be brought in the sole and exclusive jurisdiction of the State or Federal Courts located in Richland County, South Carolina. This Agreement may not be altered or amended except with CGH's written consent. You represent and warrant that you are at least 18 years of age and have the ability to understand and consent to these terms and conditions.