I give consent to Save More Drugs Clinical Services to perform a COVID-19 Antibody Test. I understand that the antibody tests look for antibodies in your blood that can fight the virus that causes COVID-19. Antibodies are proteins created by your immune system that help you fight off infections. I understand this test does not confirm that I am protected from contracting COVID-19. The testing device we use is authorized for use by the FDA in the United States, however, like many other tests, is not FDA approved. I understand that there is a slight risk of receiving a false negative or a false positive result.
I have received a copy of the notice of Privacy Practices. I understand the notice of Privacy Practices provides an explanation of the ways in which my health information may be used or disclosed by the Pharmacy and of my rights with respect to my health information. I have been provided with the opportunity to discuss concerns I may have regarding the privacy of my health information.