Section III. Signatures
I hereby give my consent to 38th Street Pharmacy to receive a COVID-19 and/or Flu test. I understand that no test is 100% accurate, and there is a chance that the results may not accurately reflect my infection status. I am expected to arrive on time to my appointment, and I understand that my test may not be rescheduled. I consent to having my results sent via the email provided above.
* I also understand that due to the sensitivity and availability of this test, I am not entitiled to a refund under any circumstance.
If you have questions, please call us at 512-458-3784.
This form is HIPAA compliant and secure. Any and all information you enter will only be viewed by the staff of 38th Street Pharmacy.
*PLEASE REMAIN IN YOUR VEHICLE AND CALL WHEN YOU ARRIVE