4. Despite sections 2 and 3, a pharmacist may not prescribe medication where the health problem is accompanied by one of the following elements:
(1) a recurrent or persistent sign or symptom after the first medication prescribed by the pharmacist is taken;
(2) a sign or a symptom suggesting the presence of an undiagnosed chronic or systemic disease;
(3) a sign or symptom suggesting a decline or alteration in the functioning of an organ or a system;
(4) an unusual reaction to the medication.
The pharmacist must then refer the patient to a professional empowered to assess his or her state of health and enter the reasons justifying the decision on a form to be given to the patient.