By signing below I understand:

• I am consenting to receiving a point-of-care test with Tarrytown Pharmacy.
• No test is 100% accurate, and there is a chance that the results of the test may or may not accurately reflect my diagnostic status.
• I do not hold Tarrytown Pharmacy LLC or any employee or other representative of Tarrytown Pharmacy responsible for any consequence of a positive, negative, or inconclusive result.
• Due to the nature of point-of-care testing, there is a risk that I may be exposed to or infected by proceeding with my scheduled testing and hereby fully assume all risks which include without limitation, the need for additional testing, a positive diagnosis, required quarantine or self-isolation, hospitalization, treatment in an intesive care unit and intubation or ventilation support, death, and/or other medical complications.
• Tarrytown Pharmacy may have an obligation to report test results to governmental or other public health authorities pursuant to applicable law and regulations and I hereby consent to any such reporting by Tarrytown Pharmacy. 
• In the event that my employer pays (whether directly or indirectly) for my test, then I hereby consent to Tarrytown Pharmacy disclosing the results of my test to my employer.
• Under no circumstance am I entitled to a refund. 
• I am expected to arrive on-time to my appointment.
• If I am late or miss my appointment, I understand that my test may not be rescheduled and I am not entitled to a refund.