Are you now or have you ever been treated for any of the following: (check all that apply)
If you checked any of the above, please elaborate here on your conditions and treatment:
By typing my full name in this box, I am effectively signing and agreeing to the following: I am only seeking this antibiotic preparedness pack in order to be prepared for a situation where conventional medical care may not be available. I further agree that if such a "grid-down" situation does not exist, and I have a condition that may require antibiotics, that I will seek evaluation and treatment at my local medical facility.
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