Patient Consent
Please carefully read the following informed consent.
- I authorize Molecular Vision Laboratory to conduct testing on the specimen I provide today.
- I authorize my test results to be disclosed to the county, state, or to any other governmental entity as may be required by law.
- I acknowledge that a negative result is not enough to rule out the presence of illness and should be understood along with current symptoms and medical history.
- I understand that I am not creating a patient relationship with Molecular Vision Laboratory by participating in testing. I understand the testing unit is not acting as my medical provider. Testing does not replace treatment by my medical provider. I assume complete and full responsibility to take appropriate action with regards to my test results. I agree I will seek medical advice, care and treatment from my medical provider if I have questions or concerns, or if my condition worsens.
- I understand that, as with any medical test, there is the potential for false positive or false negative test.
I, the undersigned, have been informed about the test purpose, procedures, possible benefits and risks, and I have received a copy of this Informed consent. I have been given the opportunity to ask questions before I sign, and I have been told that I can ask other questions at any time. I voluntarily agree to testing.