To the fullest extent permitted by law, I hereby release, discharge and hold harmless, Alan Morrison, DO, LLC including, without limitation, any of its respective officers, directors, employees, representatives and agents from any and all claims, liability, and damages, of whatever kind or nature, arising out of or in connection with any act or omission relating to my COVID-19 test or the disclosure of my COVID-19 test results.
I acknowledge and agree that I have read, understand, and agree to the statements contained within this form. I have been informed about the purpose of the COVID-19 test, procedures to be performed, potential risks and benefits, and associated costs. I have been provided an opportunity to ask questions before proceeding with a COVID-19 test and I understand that if I do not wish to continue with the collection, testing or analysis of a COVID-19 test, I may decline to receive this service. I voluntarily consent to undergo rapid testing for COVID-19.