Diagnostic Blood Test Waiver
Purpose of Diagnostic Blood Testing
East Coast IV offers diagnostic blood testing to assess your health status and determine potential eligibility for services provided by our clinic. The results of these tests will help guide our recommendations for your care. By signing this waiver, you acknowledge and agree to the following terms and conditions.
Acknowledgment of Third-Party Laboratory Fees
Blood testing is conducted by LabCorp, a third-party laboratory service.
East Coast IV does not cover LabCorp fees. These fees are separate from any charges for East Coast IV services.
If your insurance provider denies coverage for LabCorp testing, you will be solely responsible for payment of all associated costs.
East Coast IV is not responsible for disputes between you and your insurance provider or LabCorp regarding billing or coverage.
No Guarantee of Eligibility for Services
Completion of diagnostic blood testing does not guarantee eligibility for any East Coast IV services, including but not limited to IV therapies, bioidentical hormone replacement therapy (BHRT), testosterone replacement therapy (TRT), or medical weight loss (MWL).
Eligibility for any service will be determined based on the results of your blood tests, medical history, and consultation with our clinical staff, at the sole discretion of East Coast IV.
Review and Discussion of Results
East Coast IV will discuss the results of your blood tests with you during a consultation.
If your results indicate abnormal findings, these will be highlighted, and you will be advised to follow up with your primary care physician (PCP) or an appropriate specialist for further evaluation and management.
East Coast IV is not responsible for ongoing care, treatment, or follow-up related to abnormal lab results. You are responsible for coordinating and pursuing any necessary medical care with your PCP or specialist.
Risks and Responsibilities
Diagnostic blood testing involves minimal risks, including but not limited to bruising, discomfort, or infection at the blood draw site, and rare instances of fainting or dizziness.
You agree to provide accurate and complete medical history information to ensure the safety and appropriateness of testing.
You acknowledge that East Coast IV is not providing a diagnosis or treatment plan beyond the scope of assessing eligibility for clinic services.
Consent and Release
I, the undersigned, have read and understand the terms of this waiver. I voluntarily consent to diagnostic blood testing through East Coast IV and LabCorp. I acknowledge that:
I am responsible for all LabCorp fees, including those not covered by insurance.
Completing blood tests does not guarantee eligibility for any East Coast IV services, such as IV therapies, BHRT, TRT, or MWL.
I am responsible for following up with my PCP or specialist for any abnormal lab results, as advised by East Coast IV.
I release East Coast IV, its staff, and affiliates from liability for any adverse outcomes related to blood testing or the need for follow-up care.
I understand that laboratory tests are being ordered for diagnostic purposes. I acknowledge and agree to the following:
It is my responsibility to follow up on my laboratory results and to schedule any necessary appointments for further evaluation or treatment.
The provider and practice are not responsible for initiating treatment or providing urgent responses to abnormal laboratory results unless I have a scheduled follow-up appointment or have otherwise arranged for ongoing care.
If I experience new or worsening symptoms, or if I have concerns about my health, I understand that I should seek medical attention promptly and not wait for laboratory results or provider contact.
By signing below, I acknowledge that I have read and understand the above, and consent to the recommended laboratory testing.