I hereby authorize Gary & Leo’s Pharmacy to perform a COVID-19 Test. I authorize the pharmacy to maintain a copy of this signed form. I indemnify the organizing body and all persons connected with them from any and all claims that may result from my voluntary participation in the tests. I understand that my results will be submitted to the Montana Department of Health, as required by law. By signing below, I signify that I agree to allow those pharmacy employees affiliated with the pharmacy named above to administer the COVID-19 test for a fee. I understand that my insurance might not reimburse the fee for the test and hold the pharmacy and pharmacist harmless for any fees not reimbursed. Antigen tests look for viral proteins, which are highly specific, meaning that if you test positive, you are very likely infected. However, there is a higher chance of false negative with antigen tests, which means that a negative result cannot definitively rule out an active infection. If you have a negative result on an antigen test but have a recent exposure to COVID, or are displaying many of the symptoms, you may wish to take a PCR test to confirm your result. A PCR test looks for the presence of the virus' genetic material. PCR tests are highly accurate. The antigen test is most accurate if you are symptomatic and within the first five days of symptoms. If you are testing to meet a travel requirement, it is your responsibility to determine if you are required to take a PCR test or an antigen test.
Please avoid contact with others and go straight home immediately after your test. You will be contacted via phone with your results.