Please read the informed consent carefully. I, authorize CHOICE 4u LAB SERVICES LLC to conduct collection for free or Rapid COVID-19 testing througha nasopharyngeal swab. Free testing may take up to 3 business days to get the results. I acknowledge that a positive test result is an indication that I must continue to self-isolate for 14 days to avoid infecting others. I understand that the COVID-19 testing is FREE for the uninsured under the patient care act. I understand that if I do have health insurance coverage, my COVID-19 testing will be billed to my insurance provider above or insurance provided to CHOICE 4u LAB SERVICES LLC by the patient care act. I understand that there are no co-payments and deductibles for the COVID-19 testing since it's covered by my insurance provider. Iunderstand that CHOICE 4u LAB SERVICES LLC is not acting as my Primary Care Provider. Testing does not replace treatment by my medical provider. I assume complete and full responsibility to take appropriate action with regards to my test results. I agree I will seek medical advice, care and treatment from my Primary Care Provider if I have questions or concerns, or if my condition worsens. I understand that, as with any medical test, there is the potential for false positive or false negative test results.
I understand that Rapid COVID-19 testing is available for cash, debit/credit or flexible spending cards only and my insurance will NOT be billed for Rapid COVID-19 test. No refund.
I, the undersigned, have been informed about the test purpose, procedures, possible benefits and risks, and payment options. I have been given the opportunity to ask questions before I sign, and I have been told that I can ask other questions at any time. I voluntarily agree to test for COVID-19.