Please fully read and sign the following waiver and consent agreement
a) I authorize Alzein Pediatrics to conduct collection and testing for COVID 19 through a nasopharyngeal swab, as ordered by an authorized medical provider.
b) I acknowledge that a positive test result is an indication for self-isolation for 14 days.
c) I authorize my test results to be disclosed to the local health department as required by law.
d) I understand that, as with any medical test, there is the potential for a false positive or false negative COVID19 test result.
e) I understand the testing unit is not acting as my medical provider, this testing does not replace treatment by my medical provider, and I assume complete and full responsibility to take appropriate action in regard to my test results. I agree to seek further medical advice, care, and treatment from my medical provider if I have questions or concerns, or if my condition worsens.
I have read this waiver of liability and consent agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and have signed it freely and voluntarily without any inducement, assurance, or guarantee being made to me and intend my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.