If you test positive using an at-home COVID-19 test, you do not need to confirm that result by getting another test from a health care provider or testing site. If you don’t need medical care, just stay home and away from others so you don’t spread the virus to others.
Everyone who tests positive for COVID-19 should stay home for at least 5 days (day 1 is the first full day after your symptoms developed).
You can end isolation after 5 full days if you are fever-free for 24 hours (without using fever-reducing medicine) and your other symptoms are improving. You should continue to wear a well-fitted mask anytime you are around others for another 5 full days (days 6-10). You should also avoid traveling and being around people who are at high risk for severe illness.
You can learn more about COVID-19 isolation and quarantine on the CDC website: https://bit.ly/3t59ZcD
CONSENT: I understand that Peninsula Pharmacies requires a signed consent for COVID 19 testing. I hereby give consent and authorize Peninsula Pharmacies to administer and direct a COVID-19 test to me. I understand that I have a right to ask questions about my care and any recommended services. I agree to the following informed consent:
I authorize Peninsula Pharmacies to conduct specimen collection and testing for COVID-19 through a nasal or nasopharyngeal swab. A swab, which resembles a long Q-Tip, will be placed into your nasal passage to collect the specimen.
The benefit of receiving a COVID-19 test is to determine whether you are positive for COVID-19 and thus help inform your medical care and help protect the health of yourself and others.
Collection of a nasopharyngeal or nasal swab has few risks. Patients may commonly experience minor discomfort, gagging, sneezing, and coughing. Some bleeding can occur. Rare complications include infection or damage to tissues or structures in the nasal passage.
I understand that I am not required to have a COVID-19 test. Alternatively, I could decide to not proceed with testing. The risk of not testing would be not knowing whether I have COVID-19, worsening condition from delays in testing or medical care, and potentially infecting others.
I understand I that I am not creating a patient relationship with Peninsula Pharmacies by participating in testing.
I understand testing services is not acting as my medical provider. Testing does not replace treatment or advice 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, if I develop symptoms, or if my symptoms or condition worsens.
I understand that, as with any medical test, there is the potential for false positive or false negative test results. RELEASE: I also understand that in order to properly process the testing kit, I must allow Peninsula Pharmacies to share my information with other entities. I understand in some circumstances that Peninsula Pharmacies is required to share some of this information with other entities, including the WA State Dept. of Health. I consent to my sharing of my information in any form including verbal, written, and/or electronic and for my specimen to be handled, including performance of testing, with the following entities:
SPECIMENS: I understand that Peninsula Pharmacies role is to collect specimens, result specimens, and follow up with me and my provider with my specimen results. PAYMENT, INSURANCE: I assign Peninsula Pharmacies the right to bill and collect from any insurance that I have coverage with. I agree to help seek payment from my insurance provider, and am aware I may have an out of pocket expense if my insurer does not have coverage of COVID-19 testing. This out-of-pocket expense is $95.00 for the COVID-19 test. Following our attempt to bill your insurance, you will be billed for the remaining portion.
CONFIDENTIALITY: I understand services provided and any personal information shared with staff is strictly confidential within the confines of the law. I confirm I have received a copy of Peninsula Pharmacies’s privacy notice. This means that, in general, information may not be revealed to others without my specific written permission (please note permissions above). I understand certain exceptions may apply:
AGREEMENT FOR SELF ISOLATION: I understand that if I have COVID-19, I may transmit this to others. I agree to comply with the following: