Terms & Conditions

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Veritas Testing Terms Conditions

This notice of privacy provides information about how we may use and disclose protected health information about you. The notice contains a Patient Rights section describing your rights under the law. You have the right to review these Conditions before acknowledging this Consent

By accepting, you consent to our use and disclosure of protected health information about you for treatment. You have the right to revoke this Consent, in writing, signed by you. However, such revocation shall not affect any disclosures we have already made in compliance with your prior Consent. Veritas Testing, LLC its agents, officers, members and employees and its managed sites and physicians provides this form to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

:The patient understands

Protected health information may be disclosed or used for treatment, billing, health care operations and/or as required by law. I hereby authorize Veritas Testing to release any information from my test to WMI, any practitioner, doctor, hospital, or medical institution to which I may be referred to assist in my care. Additionally, I authorize Veritas Testing to provide a copy of my medical records to my primary care physician (PCP) to allow for continuity of care

Protected health information may be disclosed or used for treatment, billing, health care operations and/or as required by law. I hereby authorize Veritas Testing to release any information from my test to WMI, any practitioner, doctor, hospital, or medical institution to which I may be referred to assist in my care. Additionally, I authorize Veritas Testing to provide a copy of my medical records to my primary care physician (PCP) to allow for continuity of care

Medical Consent, Acknowledgment and Assumption of Risk

I fully understand the risks and benefits involved in participating in Covid-19 BD Veritor Antigen Test by Veritas Testing, LLC and I consent to having the screening performed. I have had all of my questions answered

I understand that this activity involves certain risks for physical injury. I also understand that there are potential risks of which I may not presently be aware. Because of the dangers of participating in this activity, I recognize the importance and agree to fully comply with the applicable laws, policies, rules and regulations, and any supervisor’s instructions regarding participation in this activity

I understand that Veritas Testing, LLC, its agents, officers, members and employees and its managed sites and physicians does not insure participants in the above-described activity, that any coverage would be through personal insurance, and has no responsibility or liability for injury resulting from this activity

I voluntarily elect to participate in this activity with knowledge of the danger involved, and I hereby agree to accept and assume any and all risks of property damage, personal injury, or death

Waiver of Liability and Indemnification

In consideration for being allowed to voluntarily participate in the above-referenced event, on behalf of myself, my personal representatives, heirs, next of kin, successors and assigns, I forever

Waive, release, and discharge the Veritas Testing, LLC, its agents, officers, members and employees and its managed sites and physicians from any and all negligence and liability for my death, disability, personal injury, property damages, property theft or claims of any nature which may hereafter accrue to me, and my estate as a direct or indirect result of my participation in the above referenced activity or event

Defend, indemnify, and hold harmless Veritas Testing LLC, its agents, officers, members and employees and its managed sites and physicians, from and against any and all claims of any nature including all costs, expenses and attorneys’ fees, which in any manner result from participant’s actions during this activity or event. This release, indemnification, and waiver shall be construed broadly to provide a release, indemnification, and waiver to the maximum extent permissible under applicable law

Understand that Veritas Testing, LLC its agents, officers, members and employees and its managed sites and clinicians does not recommend, endorse or make any representation about the efficacy, appropriateness or suitability of any specific tests, including Covid-19 BD Veritor Antigen Test, products, procedures, treatments, services, opinions, health care providers or other information that may be contained on or available through this testing service

Understand that a POSITIVE TEST may confer some immunity to COVID 19 infection, but that the science around antibodies and immunity to COVID 19 is still not certain, and that a POSITIVE TEST may not confer any immunity to COVID 19 infection. Furthermore, I understand that the WHO does not recommend the use of antibody-detecting rapid diagnostic tests for patient care but encourages the continuation of work to establish their usefulness in disease surveillance and epidemiologic research

Veritas Testing, LLC, its agents, officers, members and employees and its managed sites and physicians ARE NOT RESPONSIBLE NOR LIABLE FOR ANY FALSE POSITIVE RESULTS, FALSE NEGATIVE RESULTS, ADVICE, COURSE OF TREATMENT, DIAGNOSIS OR ANY OTHER INFORMATION, SERVICES OR PRODUCTS THAT YOU OBTAIN THROUGH THIS SERVICE

Understand that all of the health care clinicians affiliated with Veritas Testing, LLC are independent practitioners and may be members of the medical staff at one or more hospitals and are typically neither employees nor agents of the hospitals. In either case, Veritas Testing, LLC is not responsible for the care provided by these clinicians

I, the undersigned participant, affirm that I am at least 18 years of age and am freely acknowledging this agreement. I have read this form and fully understand that by acknowledging this form I am giving up legal rights and/or remedies which may otherwise be available to me regarding any losses I may sustain as a result of my participation. I agree that if any portion is held invalid, the remainder will continue in full legal force and effect

I HAVE READ THE ENTIRE DOCUMENT BEFORE ACKNOWLEGING