Patient Intake
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TEST RESULTS: Due to essential business necessity and to ensure the safety of other employees or guests, I consent to being tested for COVID-19 as offered by my Employer or Host and authorize my results to be released to an agreed party.PCR Tests: Patients who test positive will be notified via telephone while negative results will be provided to the Employer or appropriate party to distribute. Due to an increase in demand, I understand that lab processing can take longer than anticipated, and the Practice is not responsible for any delays in results once the samples have been delivered to the laboratory. In the event that a sample is not able to be processed, the patient has the option to be retested at the Practice’s office without any service charge except for the lab fee.Antigen Tests: Antigen tests are performed using the BD Veritor Plus System, which was granted Emergency Use Authorization (EUA) by the FDA. Clinical studies show the BD Veritor Plus contains a sensitivity (PPV) rating of 84% and a specificity rating (NPV) of 99%. CDC guidelines recommend positive antigen tests be followed by a PCR test for confirmation.I understand that the terms herein are contractual and not a mere recital; and that I sign this document as my own free act and void of any coercion. The permissions granted herein shall begin on the date listed below and shall remain effective until terminated by the undersigned. My signature below verifies that I have read all the information contained in this Medical Consent Form and that I have asked questions about anything I have not understood.

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