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4
Questions
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HIPAA
Compliance
1
Name
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First Name
Last Name
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2
Date of test
*
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Date
Month
Day
Year
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3
Phone Number
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4
File Upload
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Please make sure that uour name, date of Birth and date of test is indicated in the result submitted. For Home test kits, this should be indicated in the card or field when taking a picture of the result.
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