COVID-19 Testing Consent
I authorize specimen collection with an oropharyngeal swab, nasopharyngeal swab, saliva, and/or collection of blood through venipuncture and/or fingerstick for SARS-CoV2, the virus that causes COVID-19. I further understand, agree, certify, and authorize the following:
- I authorize EDP Biotech Corporation to collect the specimen.
- I have the right to refuse testing.
- This test involves a long swab to be placed into my mouth or nose all the way to my throat in an area called the Oropharynx or Nasopharynx. It may be uncomfortable, painful, or potentially cause mild abrasion or bleeding. No long-lasting side effects from testing are expected. I understand that there is minimal risk with collection of a specimen with an OP or NP swab. I acknowledge that the nature of the collection will cause slight discomfort.
- I understand that Risks and Complications of the blood draw include: Pain on the draw entry, bruising, I may become lightheaded, inflammation of the vein and rare risk of infection.
- I understand a fingerstick can be painful and may cause discomfort for a couple of days.
- EDP Biotech Corporation has contracted with Premier Medical Laboratories and Integrity Laboratories for laboratory analysis and report of my specimen. I authorize Premier Medical Laboratories or Integrity Laboratories to perform testing on my specimen.
- I understand that processing of the specimen and results may take between 1 to 4 days.
- Premier Medical Laboratories and Integrity Laboratories will provide test results to EDP Biotech Corporation, who will then forward the results to me. I authorize EDP Biotech Corporation to release test results or other information necessary to my medical provider and to me.
- I have received the “Fact Sheet for Patients regarding the Molecular Laboratory Developed Test (LDT) COVID-19 Authorized Tests”, as required by FDA.
- I understand that Premier Medical Laboratories and Integrity Laboratories has infectious disease reporting responsibilities under applicable governmental regulations and will report my testing information in accordance with these regulations.
- I understand that I am not entering into a doctor-patient relationship with EDP Biotech Corporation or its ordering physician, Dr. Michael J Bauer, MD, and that any questions or required follow up shall be my responsibility to arrange with my own physician.
By Checking “I Consent” at checkout, I acknowledge that I have read, understand, agree, certify, and/or authorize the information above and further agree that I and my heirs, executors and assigns hereby release Dr. Michael Bauer, MD, Premier Medical Laboratories, Integrity Laboratories, and EDP Biotech Corporation, including its employees, agents, and contractors from any and all liability and claims.
- An opportunity to ask questions about the above information and consent has been given to me.
- My questions have been answered to my satisfaction.
- I understand I have the right to refuse testing.
- I understand my signature represents consent to testing and results being received by EDP Biotech Corporation and my Medical Provider.
- I understand that results may be given to my EMPLOYER.
- I understand that, if positive, I will be required to stay home. I will need to isolate/quarantine myself from all people (including those I live with, if at all possible) for at least 14 days. I will not be able to return to work unless all of the following have occurred: (1) Two negative tests in a row, at least 24 hours apart; (2) I am not experiencing a fever (without the use of fever-reducing medicines); and (3) Any other respiratory symptoms I am experiencing (for example, cough or shortness of breath) have improved.